Prognosis of acute coronary insufficiency

The syndrome of acute coronary insufficiency includes patients with typical chest pain suggestive of acute myocardial infarction, with ST-T changes but no Q wave and normal CPK, GOT and LDH activities. A follow-up of 12-30 months on 56 patients admitted to a coronary care unit and discharged with the diagnosis of acute coronary insufficiency according to the above criteria is presented. Most of the complications, acute myocardial infarctions or mortality, occurred during the first few months after discharge. The mortality rate was 5.6% in the first month, 9.5% within six months and 11% during the first year. Mortality was highest in patients with chest pain which persisted for 48 hours or longer. The ECG was not helpful in prognosis. Because of the great heterogeneity of cases included in this entity, prognosis is very difficult.