Hurtado Buen Abad L, Toledo G, Cárdenas M
Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
Arch Inst Cardiol Mex. 1991 Mar-Apr;61(2):163-72.
The mortality rate of acute myocardial infarction (AMI) has decreased from 50% in 1926 to 9% nowadays. The reason for this change has been the development of coronary care units, the use of new inotropic agents, antiarrythmic drugs, pacemakers, as well as the better knowledge of the right ventricular infarction and heart failure. We studied 100 fatal AMI (group II) out of 1187 patients admitted to the Instituto Nacional de Cardiologia "Ignacio Chávez" CCU up to august 1987 and compared them with 500 survivors of acute coronary occlusion in the same period., (group I) - In both groups there were more men between 50 and 70 years. Females older than 60, had a higher mortality rate. Twenty patients died with clinical evidence of tamponade, five of them had left ventricular rupture at autopsy. The fatal AMI group had higher rates of past history of myocardial infarction, also higher rates of persistent angina, myocardial re-infarction, 3er degree AV block and RBBB. The more frequent causes of death were grade III-IV heart failure and left ventricular wall rupture.
急性心肌梗死（AMI）的死亡率已从1926年的50%降至如今的9%。这一变化的原因在于冠心病监护病房的发展、新型强心剂、抗心律失常药物、起搏器的使用，以及对右心室梗死和心力衰竭有了更深入的了解。我们研究了截至1987年8月入住国家心脏病学研究所“伊格纳西奥·查韦斯”冠心病监护病房的1187例患者中的100例致命性AMI（第二组），并将其与同期500例急性冠状动脉闭塞幸存者（第一组）进行比较。在两组中，50至70岁的男性更多。60岁以上的女性死亡率更高。20例患者死于心包填塞的临床证据，其中5例尸检时有左心室破裂。致命性AMI组有更高的心肌梗死既往史发生率，持续性心绞痛、心肌再梗死、三度房室传导阻滞和右束支传导阻滞的发生率也更高。更常见的死亡原因是III - IV级心力衰竭和左心室壁破裂。
