Myocardial infarction without anticoagulant therapy

Doscher, Ned; Poindexter, Charles A.

doi:10.1016/0002-9343(50)90309-3

Cited by 73 publications

(6 citation statements)

References 29 publications

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“…In some respects differences were found. Anterior infarcts were related to a higher mortality than inferior, confirming the finding of Norris et al (1973) and at variance with those of Doscher and Poindexter (1950) and Beard et al (1960). Norris et al found a difference between transmural and intramural infarction, whereas Scheinman and Abbott (1973) did not; the present study gave only marginal support to the former.…”

Section: Discussionsupporting

confidence: 89%

Prognosis of patients with acute myocardial infarction admitted to a coronary care unit. I: Survival in hospital.

Kitchin¹,

Pocock²

1977

Heart

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On a basis of history, clinical examination, and the electrocardiogram it was possible to identify groups of patients with acute myocardial infarction with good and bad prognoses as regards hospital survival. Individual adverse factors were age, prevous history of ischaemic heart disease, anterior infarction, persistent sinus tachycardia, pulmonary crepitations, hypotension, and raised venous pressure. Multivariate analysis showed four factors remaining significant--age, tachycardia, hypotension, and pulmonary crepitations. As a result of treatment of cardiac arrest, hospital mortality, which would otherwise have been 20 percent, was 17 percent. Preceding unstable angina did not worsen the immediate prognosis.

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Section: Discussionsupporting

confidence: 89%

Prognosis of patients with acute myocardial infarction admitted to a coronary care unit. I: Survival in hospital.

Kitchin¹,

Pocock²

1977

Heart

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“…The frequency of DM in our patients with AM1 was 6.2% (4.444% with 95% confidence limits), a little lower than the range of 8-18% reported by other authors (5,9,10,18). The patients admitted to the CCU were in no way selected according to age or other disease.…”

Section: Discussioncontrasting

confidence: 66%

Diabetes Mellitus and Acute Myocardial Infarction

Kvetny

1976

Journal of Internal Medicine

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A series of 597 consecutive patients with acute myocardial infarction (AMI) have been screened for diabetes mellitus (DM). Six per cent of the series had DM, which is exactly the frequency of DM in an age-matched population. This finding corresponds with results of other investigators, indicating that treated diabetics do not have an increased risk of AMI. Diabetics suffering from AM1 do not have an increased mortality, nor do patients treated with oral antidiabetics have a higher mortality than those treated with insulin.

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“…Doscher and Poindexter (1950) collected statistics from reported cases that showed a mortality of 18 per cent for the first attack of cardiac infarction and 30 per cent for second attacks. Our own experience is similar though the difference between the two groups is smaller: of 91 patients who gave no history of any previous cardiovascular disease, 16 died (17 -6%); of 58 patients with a history of one or more previous infarcts, 13 died (2255%).…”

Section: Previous Historymentioning

confidence: 99%

“…Regarding angina itself, opinions differ. Doscher and Poindexter (1950), Fisher and Zukerman (1946), and Rosenbaum and Levine (1941) all think that a previous history of angina makes the prognosis morefavourable. Selzer (1948) and Woods and Barnes (1942) state that it has no effect on the mortality from cardiac infarction.…”

Section: Previous Historymentioning

confidence: 99%

A Coronary Prognostic Index for Grading the Severity of Infarction

Peel

Semple²,

Wang³

et al. 1962

Heart

408

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The wide variation in severity of cardiac infarction is well known. At one extreme the patient is admitted in severe irreversible shock, cold, clammy, and dazed with a rapid feeble pulse, low or perhaps immeasurable blood pressure, and widespread changes of severe degree in the cardiogram: his chances of surviving the acute stage of the illness are indeed slender. At the opposite extreme is the patient with cardiac pain, perhaps felt only on effort, of good colour, without shock or breathlessness, with normal pulse and blood pressure, and with limited cardiographic changes: such a patient is most unlucky if he does not survive the acute stage. Between these all possible gradations are met. As a consequence very large numbers are required (preferably 200 or more) if two groups on different therapeutic regimes are to be compared. With smaller groups, even though sampling has been strictly random, one is often left with the impression that one group has contained a larger number of the more serious cases.It seemed to us that a numerical system might be devised that would express the severity in an individual case, on lines similar to the "diagnostic score" advocated for thyrotoxicosis (Crooks, Murray, and Wayne, 1959). Such a system has previously been proposed by Schnur (1953a andb and) but we feel that in some respects this was too detailed while in others it left too much latitude for individual opinion; for example, the complication of diabetes might be allotted anywhere between 10 and 25 on his scoring system. We have attempted to devise a system in which the number of factors to be taken into account is kept to the minimum compatible with providing a reasonably close correlation between the total score and the mortality expectation. We have tried to limit the latitude allowed to the observer by defining strict criteria for the award of a given score for each factor. We have aimed at producing a method that can be easily memorized and rapidly applied, and one where the possibility of observer error is minimized. We fully realize that it is impossible to eliminate observer error completely: for example, in a borderline case one observer might well regard a patient as mildly shocked while another would classify him as having no shock. The more strictly we define the conditions qualifying for "black marks," the less room there will be for such differences of opinion.A study of data collected since 1930 has convinced us that the important factors covering the immediate prognosis (i.e. the prognosis for the first four weeks) after cardiac infarction are age, sex, previous history, degree, and severity of shock, prese4ce and severity of heart failure, cardiac rhythm, and the nature and extent of cardiographic signs. We shall discuss these factors individually. METHOD AND MATERIALInitially we drew up a purely arbitrary score for each factor, based on our general clinical impression of its importance for prognosis. We

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Myocardial infarction without anticoagulant therapy

Cited by 73 publications

References 29 publications

Prognosis of patients with acute myocardial infarction admitted to a coronary care unit. I: Survival in hospital.

Prognosis of patients with acute myocardial infarction admitted to a coronary care unit. I: Survival in hospital.

Diabetes Mellitus and Acute Myocardial Infarction

A Coronary Prognostic Index for Grading the Severity of Infarction

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