Epidemiology of myocardial infarction in France : Therapeutic and prognostic implications of heart failure during the acute phase.
Background The aim of this study was to assess the 1-year outcome of acute myocardial infarction, in current practice, according to the presence or absence of heart failure.
This was an epidemiologic, prospective survey involving 2152 patients recruited in November 1995 from 312 French coronary care units.
Methods and Results All consecutive patients admitted within 48 hours for confirmed acute myocardial infarction to the participating centers in November 1995 were included.
For each patient, baseline parameters, as well as clinical course and therapeutic treatment during the first 5 days, were collected.
For the purpose of this study, the diagnosis of heart failure required a left ventricular ejection fraction <=35% and/or a Killip class>1. During the 1-year follow-up, date and cause of death were recorded.
Kaplan-Meier survival curves were analyzed with the log rank test.
Cox multivariate analyses were used to assess the independent prognostic factors among 5-day survivors.
Eight hundred twenty-one (38%) patients exhibited heart failure during the first 5 days after myocardial infarction.
Patients with heart failure were 10 years older and were more likely to be hypertensive or diabetic ; use of primary revascularization (33% vs 47%, P<. 001) and bêta-blockers (40% vs 79%, P<. 001) was less frequent, whereas prescription of angiotensin-converting enzyme (ACE) inhibitors was enhanced (56% vs 41%, P<.001). (...)
Mots-clés Pascal : Infarctus, Myocarde, Homme, France, Europe, Epidémiologie, Insuffisance cardiaque, Pronostic, Traitement, Appareil circulatoire pathologie, Cardiopathie coronaire, Myocarde pathologie, Cardiopathie
Mots-clés Pascal anglais : Infarct, Myocardium, Human, France, Europe, Epidemiology, Heart failure, Prognosis, Treatment, Cardiovascular disease, Coronary heart disease, Myocardial disease, Heart disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0078852
Code Inist : 002B12A03. Création : 31/05/1999.