Rotberg T, Segovia E, Gorodezky M
Arch Inst Cardiol Mex. 1978 May-Jun;48(3):631-52.
1). In 1001 patients with acute myocardial infarction 403 cases were found (40.2%) showing possible relapse. A study was made of 125 cases (12.5%) with positive diagnosis of acute myocardial infarction relapse, and among them, 12 were found to be occurring for the third time. Is possible for the real frequency of the iterative infarction to be even higher, because many cases were dismissed (27.7%) for lacking of conclusive electrocardiographic data pointing to myocardial transmural infarction. 2). Investigations were conducted about the evolutive condition of the danger factors in the coronary profile as well in the male as in the female group. Besides, a comparative study was made about symptoms, complications, morbidity and mortality. Clinical, enzimatic and electrocardiographic proofs were found, in every case, of a new myocardial transmural necrosis which was in evolution, with waves of injury and ischemia. Thirty eight deaths were registered in hospitals (30.4%) and in 25 of these, a necropsic study was conducted. 3). This illness is more frequent among men than among women, in a 3.5 to 1 proportion. The recurrent myocardial necrosis tends to be more frequently present during the first year following the first episode. In women, the first myocardial infarction as well as the iterative infarction occur at an older age than in men. 4). The influence of personality and stress is a very important factor of danger in the iterative infarction. Familiar antecedents of ischemic cardiopathy constitute a danger factor in patients presenting a single episode of myocardial infarction; nevertheless they don't seem to have a determining influence in this group of relapsing infarction. Although this study confirms with statistics that smoking has a decisive influence in the first myocardial infarction, neither frequency nor mortality of the relapsing infarction are in any way modified by the diminishing or suppression of the smoking habit.
1). 在1001例急性心肌梗死患者中，发现403例（40.2%）有复发可能。对125例（12.5%）急性心肌梗死复发诊断阳性的患者进行了研究，其中12例为第三次复发。由于许多病例（27.7%）因缺乏指向心肌透壁梗死的确切心电图数据而被排除，所以反复梗死的实际发生率可能更高。2). 对男性和女性组冠状动脉情况中危险因素的演变状况进行了调查。此外，还对症状、并发症、发病率和死亡率进行了比较研究。在每一例中，都发现了临床、酶学和心电图证据，证明有新的正在演变的心肌透壁坏死，伴有损伤和缺血波。医院记录了38例死亡（30.4%），其中25例进行了尸检研究。3). 这种疾病在男性中比在女性中更常见，比例为3.5比1。复发性心肌坏死在首次发作后的第一年往往更频繁出现。在女性中，首次心肌梗死以及反复梗死的发生年龄比男性大。4). 个性和压力的影响是反复梗死中一个非常重要的危险因素。缺血性心脏病的家族史是首次发生心肌梗死患者的一个危险因素；然而，它们似乎对这组复发梗死患者没有决定性影响。尽管这项研究从统计学上证实吸烟对首次心肌梗死有决定性影响，但吸烟习惯的减少或戒除对反复梗死的发生率和死亡率均无任何改变。
