Natural history of coronary heart disease: A study of 586 men surviving an initial acute attack
1983; Elsevier BV; Volume: 105; Issue: 2 Linguagem: Inglês
10.1016/0002-8703(83)90523-9
ISSN1097-6744
AutoresIan Graham, Risteárd Mulcahy, N Hickey, William W. O’Neill, Leslie Daly,
Tópico(s)Cardiac electrophysiology and arrhythmias
ResumoA total of 586 men who survived an initial attack of unstable angina or myocardial infarction have been followed for up to 15 years. A policy of early mobilization and sustained risk factor advice was employed. A conservative approach to treatment was adopted during the acute and follow-up stages. Drugs were employed only for symptomatic reasons, and only two patients proceeded to coronary artery bypass surgery. Survival at 5, 10, and 15 years was 80%, 61%, and 43%. Older patients and those with more severe initial attacks had a higher mortality, but these factors did not relate to combined fatal and nonfatal recurrence of myocardial infarction. Of 22 studies reviewed, 18 report a higher mortality than does our study. Four studies, none strictly comparable, report a similar 5-year mortality. A conservative approach to management does not appear to be harmful and may be beneficial.
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