증상발현 24시간이내 사망한 급성심근경색증 환자의 위험인자 = Risk Factors Affecting the Mortality of Acute Myocardial Infarction during the First 24 Hour after Onset

다국어 초록 (Multilingual Abstract)

Background : Recently, the incidence of acute myocardial infaction has been gradually increasing as prolongation of life spans and improvements of diet and life styles in Korea. The rate of mortality and sudden death is higher than other diseases. The purpose of this study is to evaluate factors which can affect on the mortality of AMI during initial 24 hrs.
Methods : A retrospective clinical study was done on 364 consecutive patients with AMI who had been presented to Keimyung University Dong-sang Medical Center from January 1990 to May 1997(M:F ratio=254:110). The subjects were divided two groups. The Group Ⅰ was patients who had expired during the initial 24 hrs periodof AMI(47 patients, 13%), the Group Ⅱ was pateints who had survived (317 patients, 87%). We compared clinical features, EKG, laboratory results in both groups and tried to analyse the vulnarable factors.
Results : The results were as follows; 1) The mean age in Group Ⅰ (64.4 yearly) was older than in Group Ⅱ(61.3 yearly) and female gender was also higher in Group Ⅰ. The mean systolic/diastolic blood pressures of the Group Ⅰ(103/61mmHg) were lower than those of the Group Ⅱ(123/75mmHg). 2) The chest pain and mental change were noted more frequently in Group Ⅰ than in Group Ⅱ and the dyspnea was less frequent in Group Ⅰ than Group Ⅱ. 3) The higher grades of Killip classification was significantly more frequent in Group Ⅰ than in Group Ⅱ. 4) The mean onset to drug time for thrombolytics in Group Ⅰ and Group Ⅱ were 14.1 hrs and 6.6 hrs. 5) The mortality rate of the Group Ⅰ and the Group Ⅱ were respectivly 13%, 6.6%. The most common causes of death were cardiogenic shock and ventricular arrhythmia.
Conclusion : The mortality rate of initial 24 hrs of onset as form of sudden death was higher than post-24hrs group(66.2%). The factors for the higher mortality group were old age and female gender, and they were unstable in vital signs, higher Killip classifications. Therefore, these groups demand more rapid and aggressive approach than the other groups.