[A long-term follow-up of acute non-Q-wave myocardial infarction with clinicopathologic correlation].

A long-term follow-up study of 21 cases with 24 attacks of acute non-Q-wave myocardial infarction (MI) was reported. These cases had been followed up for an average of 21.1 months, the longest being 7 years and the shortest only 8 days in a fatal case. It was shown that in the acute stage the mortality rate of non-Q-wave MI (14.3%) was slightly lower than that of Q-wave MI (18.9%). However, at the end of 2 years the cumulative mortality rate of non-Q-wave MI (33.3%) was higher than that of Q-wave MI (26.2%) and the rate of reinfarction during the follow-up in the former (38%) was much higher than that in the latter (17.3%). Among the 21 patients, 11 died of cardiac or noncardiac causes during the follow-up. Autopsy was obtained in 9 of the 11 cases. Clinicopathological correlation showed that the present diagnostic criteria for non-Q-wave MI with positive findings in clinical manifestation, electrocardiography and serum enzyme is practical and reliable. 3 of the 9 autopsied cases with negative serum enzyme were also proved to have subendocardial infarction pathologically, but in 2 of them the thickness of the lesion was less than one third of that of ventricular wall. It is, thus, concluded that although non-Q-wave MI has better prognosis in the acute stage, yet its outlook in the long run is by no means good. Moreover, negative serum enzyme does not preclude the possibility of non-Q-wave MI.