Clinical characteristics, hospital morbidity and mortality, and up to 1-year follow-up events of acute myocardial infarction patients: the first report from Iran.

BACKGROUND

Few data exist about the clinical epidemiology of acute myocardial infarction and its complications and mortality in Iran. To fill this knowledge gap, we studied clinical characteristics and the outcome for a group of Iranian patients with acute myocardial infarction, who were, for the first time in our country, followed after discharge from hospital for 1 year.

METHODS

All patients (139 individuals) with confirmed acute myocardial infarction who were treated at the coronary care unit of Dr Shariati Hospital and followed up over a 1-year period (June 2002 to June 2003) were prospectively studied. Numerous relevant variables including epidemiologic data, treatments received, in-hospital course and complications were recorded. The survivors were followed at 1, 6 and 12 months after discharge.

RESULTS

In all, there were 101 men and 38 women aged 58.6+/-11.8 years. Only 35.9% of patients received thrombolytic therapy, and primary percutaneous coronary intervention was performed in 6.4% of cases. In-hospital death occurred in 21 of 139 (15.1%), with an equal distribution between the two sexes. One-month, 6-month and 12-month cumulative mortality rates were 17.3, 20.1 and 21.6%, respectively.

CONCLUSION

Although our patients were younger than myocardial infarction patients in developed countries, they had a higher rate of in-hospital mortality than those of the international statistics. This may be due, in part, to the lower rate of administration of primary reperfusion strategies in our center, namely primary percutaneous coronary intervention and thrombolytic therapy, which have proved to be effective in reducing the mortality from myocardial infarction in the west. Wider application of primary percutaneous coronary intervention, in particular, is recommended.