[Acute myocardial infarct in a metropolitan area].

In a retrospective study the course of acute myocardial infarction was investigated in 1840 patients treated in 1980 in eleven Hamburg hospitals (90% of hospitals admitting emergencies). 71% of patients were over 60 years of age, infarction frequency reached its peak in the eighth decade. Compared to prior investigations the percentage of women was higher both as a whole and in patients over 70 years of age (ratio men to women = 1.8 : 1). In comparison with the overall population of Hamburg, infarction rate was not increased in certain social classes. Frequency of "silent" infarctions was 4 to 5 times higher in patients of 70 years of age than in younger ones. Left ventricular failure and conduction disturbances increased with age, while extrasystoles occurred at all ages without difference. Hospital mortality of acute infarction was 29% for men and 37% for women. Striking results are the higher mortality of younger women and the considerable increase of mortality in patients over 70 years of age, probably due to change of age structure, the large number of acute reinfarctions (29%), and the short admission time. 40% of patients of all age-groups were admitted within 3 hours after onset of infarction.