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Ji Hoon Kang, Jong Seon Park, Jang Won Son, Hyeun Su Jo, Jun Ho Bae, Geu Ru Hong, Dong Gu Shin, Young Jo Kim, Bong Seup Sim |
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부산대학교 의과대학 내과학교실 |
| 원저 : 급성심근경색증 환자의 사망률과 예후인자 및 사인 (Original Articles : Mortality, prognostic factor and cause of death of acute myocardial infarction in Korean patients: single center experience) |
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강지훈, 박종선, 손장원, 조현수, 배준호, 홍그루, 신동구, 김영조, 심봉섭 |
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| Abstract |
Background : The number of patients suffering from acute myocardial infarction is on the
increase in Korea due to the westernization of life style. Recent improvement of therapeutic stratigies
have shown early mortality benefits in acute myocardial infarction. But we don't have data how
many patients died and what's the cause of death in these patients. This study aimed to find out the
mortality rate, cause of death and it's relevant prognostic factors of myocardial infarction (MI)
patients who admitted alive, and to construct a database which will be used to develop a risk
stratification strategy for the implementation of new preventive therapeutic modalities, such as
implantable cardioverter-defibrillator (ICD).
Methods
: Seven hundred and forty two MI patients admitted to our hospital from March, 1999
to August, 2002 were included in this study. The risk factors and survivals were evaluated by
medical record searching and telephone survey in these patients.
Results
: The average age was 64 years-old and 67% was male. During the mean follow up 20.7
¡¾15.4 months, total 105 cardiac death (14.2%) was occurred and cumulative mortality rate at 1 year
and 2 year was 5.69% and 10.80%, respectively. Of the total 129 death, in-hospital death was 68
(cardiac death 48, non-cardiac death 20) and out of hospital death was 60 (cardiac death 57,
non-cardiac death 4). When it comes to cause of death, most common cause of cardiac death was
malignant arrhythmia. The proportion of malignant arrhythmia in cardiac death was 81.3% and 72%
of in-hospital and out of hospital death, respectively. Multivariate analysis showed that old age, low
LV ejection fraction and no percutaneous coronary intervention (PCI) treatment were independent
risk factors for cardiac mortality.
Conclusions
: Myocardial infarction shows still high mortality rate despite the recent development
of therapeutic strategy. As post-MI patients with low LVEF or no PCI shows high mortality, the
early reperfusion therapy should be encouraged. Additionally, because malignant arrhythmia was one of the most in cause of cardiac death, ICD therapy to prevent sudden cardiac death should be considered in an active manner.(Korean J Med 70:33-40, 2006)
Key Words : Mortality, Acute myocardial infarction, Risk factor |
| Key Words:
Mortality, Acute myocardial infarction, Risk factor |
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