The hospital course of acute myocardial infarction in the Tainan area

The hospital records of 204 patients with acute myocardial infarction (AMI) admitted from August 1988 through July 1990 were reviewed. Of these, 138 patients who were admitted within 24 hours after onset of symptoms were enrolled in this retrospective study. In 138 patients (110 men, 28 women; aged 62.6 +/- 11.3 years), the mean prehospital time was 4.8 +/- 4.5 hours (median 3.0, range 0.5 to 24.0). Ninety-nine of these 138 patients were classified as an early presentation group (less than 6 hours); their mean prehospital time was 2.5 +/- 1.3 hours. Of these, 60 patients received thrombolytic therapy with intravenous streptokinase (SK), and their prehospital time was 2.3 +/- 1.2 hours, with mean time to SK therapy of 3.7 +/- 1.5 hours. The in-hospital mortality of these 60 patients was 16.7%. The remaining 39 patients, without SK therapy, had a higher in-hospital mortality (28.2%); their mean prehospital time was 2.7 +/- 1.3 hours. For the late presentation group (greater than or equal to 6 hours), the mean prehospital time was 10.6 +/- 4.3 hours and the in-hospital mortality was 7.7%. The frequency of severe congestive heart failure (Killip class III or IV) at admission was significantly higher in patients with early presentation, than with late presentation (30.7% vs 7.6%, p less than 0.05). The overall causes of death included congestive heart failure (79%), ventricular arrhythmia (8%) and underlying medical illness (13%). In conclusion, 43.4% of the AMI patients in this study received SK therapy, within a mean time of 3.7 +/- 1.5 hours after onset.(ABSTRACT TRUNCATED AT 250 WORDS)