One-Year Outcome of Patients with Acute Myocardial Infarction

Abstract

Background: Cardiovascular disease (CVD) is the leading cause of mortality and morbidity worldwide. Acute myocardial infarction (AMI) represents the most dramatic presentation of CVD and is one of the most commonly seen acute medical emergencies. According to Iran’s Ministry of Health, 966,779 people (46%) died of CVD and 575, 257 (27%) potential years of life were lost to CVD in 2000. We, therefore, set out to evaluate the one-year outcome of the patients admitted to Loghman-Hakim Hospital between 2003 and 2004.

Methods: This historical cohort study selected patients that had been discharged from hospital a year earlier. The subjects were asked by telephone to come to the hospital so that their records could be assessed, and data on the following categories were extracted: coronary angiography results, revascularization (percutaneous coronary intervention [PCI], coronary artery bypass grafting [CABG]), re-admission, mortality and drug compliance.

Results: Among 132 AMI patients at a mean age of 59.2 years, 76.5% were male. Seventy nine point five percent of all the patients had had ST-elevation myocardial infarction (STEMI) and 20.5% non-STEMI. Fifty-eight percent of the subjects had received streptokinase and 42.4% had undergone cardiac catheterization. Revascularization had been performed on 12.8% via PCI and on 21.2% through CABG. The mortality and re-admission rates within one year of treatment stood at 6.1% and 14.3%, respectively. One year after discharge, the respective rates of drug compliance with beta-blockers, ASA, ACEI and statins were 74.2%, 98.5%, 71.2% and 67.4%.

Conclusion: Patients with AMI show satisfactory long-term drug compliance. Our patients' mortality rate was comparable to that in other studies, and their adherence to prescribed medicines and recommended procedures (PCI, CABG) was relatively high.