QJM Advance Access originally published online on June 22, 2006
QJM 2006 99(7):437-443; doi:10.1093/qjmed/hcl064
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Contemporary mortality due to acute myocardial infarction, unstable angina and exertional angina in a population in South East London
From the Department of Cardiovascular Medicine, Imperial College, London and 1Bromley Hospitals NHS Trust, London, UK
Address correspondence to Dr K.F. Fox, Cardiovascular Medicine, Imperial College London at Charing Cross Hospital, 5th Floor Lab Block, Charing Cross Hospital, London W6 8RF. email: k.fox{at}imperial.ac.uk
Background: Data on the contemporary mortality of coronary heart disease (CHD) are surprisingly sparse.
Aim: To describe the contemporary mortality of all manifestations of CHD.
Design: Prospective follow-up of patients with a first presentation of CHD in a defined population.
Methods: We studied 537 patients with a first presentation of acute myocardial infarction, unstable angina or new exertional angina in Bromley Health Authority, London (population 295 000). Patients were prospectively monitored for cardiac and non-cardiac mortality for a median of 6 years.
Results: During a median 6 years follow-up, there were 88 (16%) deaths. Survival free from cardiac death was not significantly different between unstable angina (92%) and new exertional angina (94%), but was lower for acute myocardial infarction (84%).
Discussion: Mortality from CHD appears to be falling. However, efforts to prevent myocardial infarction should continue to be a priority, because on-going early mortality remains high. New exertional angina should be diagnosed and managed promptly, as its mortality is similar to that of unstable angina.