The medical records of all patients (N = 264) admitted to King Fahd Hospital with a confirmed diagnosis of acute myocardial infarction (AMI) between January 1982 and December 1987 were retrospectively reviewed. A total of 221 males (84%) and 43 females (16%) were identified. Median age was 53.2 ± 12.3 years. Saudi patients constituted 61% of the patients, and Indians and Pakistanis were the most frequent nationalities among non-Saudis (16%), Current smoking history (57%), past medical history of coronary heart disease (48%), and diabetes mellitus (28%) were the most common risk factors encountered. Of all the patients, 54 (20%) died in hospital from AMIrelated complications. Logistic regression analysis identified cardiogenic shock, cardiac arrest, and development of severe congestive heart failure (CHF) as three adverse factors that, independently, influenced in-hospital mortality. Over a median follow-up of 32 months, 208 patients were analyzed for long-term survival. The survival curve estimated that at 36 months the survival probability (±SE) was 0.78 ± 0.06 (95% confidence interval, 66 to 90%). The multivariate proportional hazard of Cox revealed that age above 60 years, severe CHF, and withholding longacting nitrates were the only significant covariates that independently influenced long-term survival adversely. Our data indicate that efforts to combat smoking should be intensified. Furthermore, the baseline information obtained from our analysis should be compared with that derived from our newly established coronary care unit. The data also indicate that the prospective evaluation of the protective role of long-acting nitrates is warranted.
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