[Myocardial infarction--risks and procedures. Longitudinal observation of a population of 280,000 women and men--Project POL-MONICA Krakow. I V: Prognosis of non-invasive treatment in myocardial infarction within 28 days since its onset].

The objective of a paper was to assess in the observational study the early determinants of outcome in patients with acute myocardial infarction (MI)) in one province of Poland (Tarnobrzeg Voivodship). The studied group were 1858 hospitalized men and women registered in POL-MONICA Kraków study with clinical diagnosis of myocardial infarction or acute coronary heart disease, who fulfilled the criteria for definite or possible myocardial infarction according to The WHO MONICA Project. The main out-come measure was death before the end of 28th day after the onset. Patients with shock were at the highest risk to die-relative risk (RR) = 21.47, 95% confidence interval (CI) = 12.86-35.83. The other characteristics, which increased risk independently were: left ventricular failure (LVF) (RR = 2.51, 95% CI = 1.54-4.10) and age (RR = 1.03, 95% CI = 1.01-1.05) per one year. Male sex and diabetes were not related to the risk of death. After adjustment to age, sex, shock, LVF and diabetes, lower risk was found in patients treated with antiplatelet agents (RR = 0.41, 95% CI = 0.29-0.59), with beta-blockers (RR = 0.48, 95% CI = 0.31-0.75) and with nitrates (RR = 0.62, 95% CI = 0.39-0.98), which were used in 66.2%, 33.1% and 97% of events respectively. Higher risk was found in patients treated with diuretics.