Apparently coronary heart disease-free patients in the coronary care unit: Characteristics, medical care, and 1-year outcome

E. C. Brodin, Eyal Shahar, W. D. Rosamond, P. G. McGovern, J. M. Sprafka, K. M. Doliszny, R. V. Luepker

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Coronary care units (CCUs) have contributed significantly to the improved survival rates among patients with acute myocardial infarction. Many patients admitted to CCUs are certified to be free of coronary heart disease (CHD) at discharge. There is little literature on the hospital course and prognosis of such patients. Methods: We identified and followed 594 patients admitted to six CCUs in the Minneapolis-St Paul metropolitan area in 1990 because of suspected acute myocardial infarction who were eventually discharged without evidence of acute or chronic CHD. Their baseline characteristics, medical care, and 1-year outcome were compared with those of 672 patients with confirmed acute myocardial infarction and 612 patients with a history of CHD but without evidence of an acute coronary event. Results: Similar numbers of men and women were certified to be CHD-free on discharge from hospital. These patients were significantly younger than either patients with acute myocardial infarction or patients with a history of CHD (mean age 57, 65, and 67 years, respectively). CHD-free patients commonly reported current smoking, hypertension, and hypercholesterolemia (26, 50, and 18%, respectively). These patients were less likely than those with acute myocardial infarction or a history of CHD to undergo diagnostic or therapeutic procedures, or to receive pharmacological treatment. Their 1- year mortality rate was 5%, significantly lower (P < 0.05) than the mortality among patients with either acute myocardial infarction (18%) or a history of CHD (13%) but 2.6 times greater than expected in the general population. Older age, previous or current smoking, chest pain leading to admission, and congestive heart failure were independent predictors of 1-year mortality. Conclusions: Patients certified to be CHD-free after admission to a CCU with suspected acute myocardial infarction have a lower 1-year mortality rate than patients experiencing acute myocardial infarction or chronic CHD. Their mortality rate, however, is substantially higher than expected, probably because of a high prevalence of cigarette smoking and hypertension.

Original languageEnglish (US)
Pages (from-to)737-743
Number of pages7
JournalCoronary Artery Disease
Volume5
Issue number9
StatePublished - 1994
Externally publishedYes

Fingerprint

Coronary Care Units
Coronary Disease
Myocardial Infarction
Mortality
Smoking
Hypertension
Hypercholesterolemia
Chest Pain

Keywords

  • acute myocardial infarction
  • coronary care unit
  • health outcome
  • medical care
  • mortality
  • prognosis
  • surveillance
  • suspected acute myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Brodin, E. C., Shahar, E., Rosamond, W. D., McGovern, P. G., Sprafka, J. M., Doliszny, K. M., & Luepker, R. V. (1994). Apparently coronary heart disease-free patients in the coronary care unit: Characteristics, medical care, and 1-year outcome. Coronary Artery Disease, 5(9), 737-743.

Apparently coronary heart disease-free patients in the coronary care unit : Characteristics, medical care, and 1-year outcome. / Brodin, E. C.; Shahar, Eyal; Rosamond, W. D.; McGovern, P. G.; Sprafka, J. M.; Doliszny, K. M.; Luepker, R. V.

In: Coronary Artery Disease, Vol. 5, No. 9, 1994, p. 737-743.

Research output: Contribution to journalArticle

Brodin, EC, Shahar, E, Rosamond, WD, McGovern, PG, Sprafka, JM, Doliszny, KM & Luepker, RV 1994, 'Apparently coronary heart disease-free patients in the coronary care unit: Characteristics, medical care, and 1-year outcome', Coronary Artery Disease, vol. 5, no. 9, pp. 737-743.
Brodin, E. C. ; Shahar, Eyal ; Rosamond, W. D. ; McGovern, P. G. ; Sprafka, J. M. ; Doliszny, K. M. ; Luepker, R. V. / Apparently coronary heart disease-free patients in the coronary care unit : Characteristics, medical care, and 1-year outcome. In: Coronary Artery Disease. 1994 ; Vol. 5, No. 9. pp. 737-743.
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abstract = "Background: Coronary care units (CCUs) have contributed significantly to the improved survival rates among patients with acute myocardial infarction. Many patients admitted to CCUs are certified to be free of coronary heart disease (CHD) at discharge. There is little literature on the hospital course and prognosis of such patients. Methods: We identified and followed 594 patients admitted to six CCUs in the Minneapolis-St Paul metropolitan area in 1990 because of suspected acute myocardial infarction who were eventually discharged without evidence of acute or chronic CHD. Their baseline characteristics, medical care, and 1-year outcome were compared with those of 672 patients with confirmed acute myocardial infarction and 612 patients with a history of CHD but without evidence of an acute coronary event. Results: Similar numbers of men and women were certified to be CHD-free on discharge from hospital. These patients were significantly younger than either patients with acute myocardial infarction or patients with a history of CHD (mean age 57, 65, and 67 years, respectively). CHD-free patients commonly reported current smoking, hypertension, and hypercholesterolemia (26, 50, and 18{\%}, respectively). These patients were less likely than those with acute myocardial infarction or a history of CHD to undergo diagnostic or therapeutic procedures, or to receive pharmacological treatment. Their 1- year mortality rate was 5{\%}, significantly lower (P < 0.05) than the mortality among patients with either acute myocardial infarction (18{\%}) or a history of CHD (13{\%}) but 2.6 times greater than expected in the general population. Older age, previous or current smoking, chest pain leading to admission, and congestive heart failure were independent predictors of 1-year mortality. Conclusions: Patients certified to be CHD-free after admission to a CCU with suspected acute myocardial infarction have a lower 1-year mortality rate than patients experiencing acute myocardial infarction or chronic CHD. Their mortality rate, however, is substantially higher than expected, probably because of a high prevalence of cigarette smoking and hypertension.",
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T1 - Apparently coronary heart disease-free patients in the coronary care unit

T2 - Characteristics, medical care, and 1-year outcome

AU - Brodin, E. C.

AU - Shahar, Eyal

AU - Rosamond, W. D.

AU - McGovern, P. G.

AU - Sprafka, J. M.

AU - Doliszny, K. M.

AU - Luepker, R. V.

PY - 1994

Y1 - 1994

N2 - Background: Coronary care units (CCUs) have contributed significantly to the improved survival rates among patients with acute myocardial infarction. Many patients admitted to CCUs are certified to be free of coronary heart disease (CHD) at discharge. There is little literature on the hospital course and prognosis of such patients. Methods: We identified and followed 594 patients admitted to six CCUs in the Minneapolis-St Paul metropolitan area in 1990 because of suspected acute myocardial infarction who were eventually discharged without evidence of acute or chronic CHD. Their baseline characteristics, medical care, and 1-year outcome were compared with those of 672 patients with confirmed acute myocardial infarction and 612 patients with a history of CHD but without evidence of an acute coronary event. Results: Similar numbers of men and women were certified to be CHD-free on discharge from hospital. These patients were significantly younger than either patients with acute myocardial infarction or patients with a history of CHD (mean age 57, 65, and 67 years, respectively). CHD-free patients commonly reported current smoking, hypertension, and hypercholesterolemia (26, 50, and 18%, respectively). These patients were less likely than those with acute myocardial infarction or a history of CHD to undergo diagnostic or therapeutic procedures, or to receive pharmacological treatment. Their 1- year mortality rate was 5%, significantly lower (P < 0.05) than the mortality among patients with either acute myocardial infarction (18%) or a history of CHD (13%) but 2.6 times greater than expected in the general population. Older age, previous or current smoking, chest pain leading to admission, and congestive heart failure were independent predictors of 1-year mortality. Conclusions: Patients certified to be CHD-free after admission to a CCU with suspected acute myocardial infarction have a lower 1-year mortality rate than patients experiencing acute myocardial infarction or chronic CHD. Their mortality rate, however, is substantially higher than expected, probably because of a high prevalence of cigarette smoking and hypertension.

AB - Background: Coronary care units (CCUs) have contributed significantly to the improved survival rates among patients with acute myocardial infarction. Many patients admitted to CCUs are certified to be free of coronary heart disease (CHD) at discharge. There is little literature on the hospital course and prognosis of such patients. Methods: We identified and followed 594 patients admitted to six CCUs in the Minneapolis-St Paul metropolitan area in 1990 because of suspected acute myocardial infarction who were eventually discharged without evidence of acute or chronic CHD. Their baseline characteristics, medical care, and 1-year outcome were compared with those of 672 patients with confirmed acute myocardial infarction and 612 patients with a history of CHD but without evidence of an acute coronary event. Results: Similar numbers of men and women were certified to be CHD-free on discharge from hospital. These patients were significantly younger than either patients with acute myocardial infarction or patients with a history of CHD (mean age 57, 65, and 67 years, respectively). CHD-free patients commonly reported current smoking, hypertension, and hypercholesterolemia (26, 50, and 18%, respectively). These patients were less likely than those with acute myocardial infarction or a history of CHD to undergo diagnostic or therapeutic procedures, or to receive pharmacological treatment. Their 1- year mortality rate was 5%, significantly lower (P < 0.05) than the mortality among patients with either acute myocardial infarction (18%) or a history of CHD (13%) but 2.6 times greater than expected in the general population. Older age, previous or current smoking, chest pain leading to admission, and congestive heart failure were independent predictors of 1-year mortality. Conclusions: Patients certified to be CHD-free after admission to a CCU with suspected acute myocardial infarction have a lower 1-year mortality rate than patients experiencing acute myocardial infarction or chronic CHD. Their mortality rate, however, is substantially higher than expected, probably because of a high prevalence of cigarette smoking and hypertension.

KW - acute myocardial infarction

KW - coronary care unit

KW - health outcome

KW - medical care

KW - mortality

KW - prognosis

KW - surveillance

KW - suspected acute myocardial infarction

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