[Advances in the therapy of myocardial infarct. Prognosis and clinical course of acute myocardial infarct with intensive therapy].

In a group of 1319 patients with acute myocardial infarction treated in an intensive care unit from 1969-1977 30% died within the years 1969-1971 during the stay in the clinic. The hospital death-rate decreased significantly to 22% between the years 1975-1977, while the average age of the patients was increasing, inspite of an increase in haemodynamically complicated infarcts. The number of patients in the age group of 50-69 years has decreased from 56% to 41%. The number of patients aged 70 years and older increased, while lethality decreased from 53% to 32%. Lethality in patients with total AV-block decreased, and was unchanged in patients with plurifascicular blocks. The incidence of ventricular fibrillation increased, lethality in these patients decreased. The high lethality of patients with cardiogenic shock remained unchangedly high. In patients with all other forms of severe heart failure lethality decreased, even in patients aged 80 years and more. Deaths occurred later during 1975-1977 compared to former periods. The interval between the beginning of symptoms and admission to the intensive care unit decreased, but has no more any prognostic significance. Improved survival is referred to effective treatment of life threatening disorders of cardiac rhythm and of severe heart failure.