Herlitz J, Karlson B W, Hjalmarson A
Department of Medicine I, Sahlgrenska Hospital, Göteborg, Sweden.
J Intern Med. 1990 Aug;228(2):125-31. doi: 10.1111/j.1365-2796.1990.tb00205.x.
From a large randomized multicentre trial of metoprolol in suspected acute myocardial infarction (n = 5778) we report on the outcome during 1 year of follow-up, in relation to early diagnosis. Patients who developed a confirmed infarction had a 1-year mortality rate of 12.8%. This was significantly higher than the mortality rate of 6.3% (P less than 0.001) in patients with possible infarction and it was also higher than that in patients with no infarction, which was 5.0% (P less than 0.001). A multivariate analysis showed that independent risk predictors in the clinical history of patients without confirmed infarction were a history of angina pectoris, chronic use of digitalis and advanced age. After 1 year, angina pectoris was most common in patients with an initial possible infarction. These patients were also in most urgent need of bypass surgery. We thus conclude that the mortality during 1 year of follow-up among patients with an initially strongly suspected acute myocardial infarction was clearly related to whether or not the patient developed a myocardial infarction.
在一项关于美托洛尔用于疑似急性心肌梗死的大型随机多中心试验（n = 5778）中，我们报告了与早期诊断相关的1年随访结果。确诊为心肌梗死的患者1年死亡率为12.8%。这显著高于可能发生心肌梗死患者6.3%的死亡率（P < 0.001），也高于无心肌梗死患者5.0%的死亡率（P < 0.001）。多变量分析显示，未确诊心肌梗死患者临床病史中的独立风险预测因素为心绞痛病史、长期使用洋地黄和高龄。1年后，心绞痛在最初可能发生心肌梗死的患者中最为常见。这些患者也最急需进行搭桥手术。因此，我们得出结论，最初高度疑似急性心肌梗死患者在1年随访期间的死亡率与患者是否发生心肌梗死明显相关。
