Prognosis after myocardial infarction: results of 15 year follow up.

A total of 271 out of 757 patients who had suffered a myocardial infarction during 1966-7 were still alive after six years; these patients were subsequently followed up 15 years after the infarction. Two hundred and sixty eight (99%) of the patients alive at six years and 519 (95%) of the 549 originally discharged from hospital were traced. A coronary prognostic index, which had predicted survival both to three years and from three to six years after recovery from the infarct also predicted survival from six to 15 years after recovery. The major factor affecting survival to 15 years was age at the time of the original infarct. Among patients aged under 60 at the time of infarction women fared better than men (p = 0.027). Factors in the coronary prognostic index that were associated with impairment of left ventricular function at the time of infarction and that had predicted mortality to three years and from three to six years also predicted mortality from six to 15 years. These factors were cardiac enlargement, pulmonary venous congestion, and the presence of infarction before the index infarct. The dominant cause of death remained coronary heart disease and its complications.

The effect of centrifugal force on glycosaminoglycan production by aortic smooth muscle cells in culture.

Cultured smooth muscle cells from pig aorta subjected to centrifugation (48 h at 45 g over a 72-h period) increased their production of glycosaminoglycans by approximately 50%. The sulphated components, heparan sulphate, dermatan sulphate and chondroitin sulphate, showed a relatively greater increase than hyaluronic acid (66-34%). The results are consistent with the hypothesis that mechanical stress, such as hypertension, leads to increased accumulation of glycosaminoglycans in the aortic wall and that secondary trapping of lipoproteins by sulphated glycosaminoglycans produces atherosclerotic plaques.