Contemporary mortality due to acute myocardial infarction, unstable angina and exertional angina in a population in South East London

Abstract

Background: Data on the contemporary mortality of coronary heart disease (CHD) are surprisingly sparse. Aim: To describe the contemporary mortal ity of all manifestations of CHD. Design: Prospective follow-up of patients with a first presentatio n of CHD in a defined population. Methods: We studied 537 patients with a first presentation of acute myocardial infarction, unstable angina or new exertional angina in Bromley Health Authority, London (population 295 000). Patients were prospectively monitored for cardiac and non-cardiac mortality for a median of 6 years. Results: During a median 6 years follow-up, there were 88 (16%) deaths. Survival free from cardiac death was not significantly different between unstable angina (92%) and new exertional angina (94%), but was lower for acute myocardial infarction (84%). Discussion: Mortality from CHD appears to be falling. However, efforts to prevent myocardial infarction should continue to be a priority, because on-going early mortality remains high. New exertional angina should be diagnosed and managed promptly, as its mortality is similar to that of unstable angina. © 2006 Oxford University Press.