Nonfatal myocardial infarction in medically treated patients with coronary artery disease

The purpose of this study was to identify patient characteristics associated with nonfatal myocardial infarction as the first event after cardiac catheterization in medically treated patients with coronary artery disease. Multiple logistic risk analyste of 81 baseline characteristics in 354 patients who died or had nonfatal infarction identified 10 characteristics (5 clinical and 5 cardiac catheterization variables) as independently discriminating between the two events. Left ventricular function, specific coronary anatomy, previous myocardial infarction and age were the most important discriminators. Poor left ventricular function and left main coronary stenosis were associated with death. Subtotal left anterior descending and right coronary arterial stenosis, normal hemodynamics, absence of previous infarction and young age were associated with nonfatal infarction. Thus, in any subset of patients who have a uniform risk of ischemic events (nonfatal infarction or death), nonfatal infarction is most likely to occur in those who are young, have had no previous infarction, have subtotal left anterior descending and right coronary arterial stenosis and normal hemodynamics.