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QJM Advance Access published online on June 22, 2006
QJM, doi:10.1093/qjmed/hcl064
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© The Author 2006. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: Journals.permissions@oxfordjournals.org

Original Papers

Contemporary mortality due to acute myocardial infarction, unstable angina and exertional angina in a population in South East London

K.F. Fox 1 *, T. Collier 1, D.A. Wood 1, J. Serhan 2, S. Sutcliffe 2, F. Akhras 2, and E. Langford 2

1 From the Department of Cardiovascular Medicine, Imperial College, London, UK
2 From the Bromley Hospitals NHS Trust, London, UK

* To whom correspondence should be addressed.
K.F. Fox, E-mail: k.fox{at}imperial.ac.uk


  Abstract

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.


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