Monitoring myocardial infarct (diagnostic combination,prodromal period,behavioral characteristics) using the WHO program "Registry of Acute Myocardial Infarct", Monica

AIM: A 22-year study of diagnostic categories of myocardial infarction (MI), a prodromal period, behavioral characteristics of the patients. MATERIAL AND METHODS: WHO programs Acute Myocardial Infarction Register and MONICA were performed in Novosibirsk population aged 25-64 years. From January 1, 1977, to December 31, 1998, monitoring registered 5180 cases of MI (1774 lethal outcomes). RESULTS: The diagnostic category "Possible" MI occurred more frequently than "definite" MI, this difference being more noticeable in women than in men. In both diagnostic categories the disease presented with a typical clinical picture. In the category "definite" MI there were many cases of atypical disease. Most cases of MI developed at home though it occurred outdoors more frequently in men and at home in women. Half of the patients had arterial hypertension (AH) and effort angina (EA), one third of the patients had survived MI before. 91% of MI men were heavy smokers. Alcohol intake at MI onset was insignificant. Pain syndrome 2 weeks before MI was the same in survivors and the deceased. Those who died suddenly felt extremely tied before MI, those whose death was not sudden experienced exacerbation of EA and dyspnea, those who survived experienced exacerbation of EA. CONCLUSION: Long-term monitoring showed that MI clinical presentation did not differ for 2 decades. A significant number of MI patients with a history of hypertension, effort angina, previous MI, heavy smoking evidenced for the lack of prophylactic education among population.