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Early Discharge Following Acute Myocardial Infarction: Long-term Follow-up of Randomized Patients

Early Discharge Following Acute Myocardial Infarction: Long-term Follow-up of Randomized Patients Abstract Long-term follow-up was obtained on 138 patients who participated in a prospective, randomized study comparing two weeks with three weeks of hospitalization following uncomplicated acute myocardial infarction. Follow-up information was available on 123 (89%) of all randomized patients. The mean follow-up period was 35 months for those patients who died and 99 months for those who survived. No differences were found between the two groups with respect to survival, cardiac-related deaths, frequency or severity of angina pectoris, subsequent myocardial infarction, incidence of congestive heart failure, number of ventricular aneurysms, or subsequent medical therapy. A significantly greater number of survivors in both groups stopped smoking and had a normal initial heart size than those who died. This long-term follow-up study further supports the conclusions of earlier short-term studies that two weeks of hospitalization is safe in patients with uncomplicated acute myocardial infarction. Back to top Article Information Reprint requests to Massachusetts General Hospital, Fruit Street, Boston, MA 02114 (Dr Hutter). This study was supported by Public Health Service grant HL17665. Theresa Flynn, RN, Aletha Roberts Niles, RN, and Kathy Donnick assisted in this investigation. References 1. Hutter AM Jr, Sidel VW, Shine KI, et al: Early hospital discharge after myocardial infarction. N Engl J Med. 1973;288:1141-1144.Google ScholarCrossref 2. McNeer JF, Wagner GS, Ginsburg PB, et al: Hospital discharge one week after acute myocardial infarction. N Engl J Med. 1978;298:229-232. PubMedGoogle ScholarCrossref 3. Harpur JE, Conner WT, Hamilton M, et al: Early mobilization and discharge from hospital in uncomplicated myocardial infarction. Lancet. 1971;2:1331-1334.Google ScholarCrossref 4. Harpur JE: Shorter hospitalization for myocardial infarcts. N Engl J Med. 1973;289:805.Google ScholarCrossref 5. Bloch A, Maeder J-P, Haissly J-C, et al: Early mobilization after myocardial infarction: A controlled study. Am J Cardiol. 1974;34:152-157. PubMedGoogle ScholarCrossref 6. Hayes MJ, Marris GK, Hampton JR: Comparison of mobilization after two and nine days in uncomplicated myocardial infarction. Br Med J. 1974;2:10-13. PubMedPubMedGoogle ScholarCrossref 7. Swan HJC, Blackburn HW, DeSanctis RW, et al: Duration of hospitalization in 'uncomplicated completed acute myocardial infarction': An ad hoc committee review. Am J Cardiol. 1976;37:413-419.Google ScholarCrossref 8. Abraham AS, Sever Y, Weinstein M, et al: Value of early ambulation in patients with and without complications after myocardial infarction. N Engl J Med. 1975;292:719-722. PubMedPubMedGoogle ScholarCrossref 9. McNeer JF, Wallace AG, Wagner GS, et al: The course of acute myocardial infarction: Feasibility of early discharge of the uncomplicated patient. Circulation. 1975;51:410-413. PubMedPubMedGoogle ScholarCrossref 10. Oberman A, Jones WB, Riley CP: Natural history of coronary artery disease. Bull NY Acad Med. 1972;48:1109-1125.Google Scholar 11. Slone D, Shapiro S, Rosenbert L, et al: Relation of cigarette smoking to myocardial infarction in young women. N Engl J Med. 1978;298:1273-1276. PubMedGoogle ScholarCrossref 12. Dall R, Peto R: Mortality in relation to smoking: 20 years' observations on male British doctors. Br Med J. 1976;2:1525-1536. PubMedGoogle ScholarCrossref 13. Wilhelmsson C, Elmfeldt D, Vedin JA, et al: Smoking and myocardial infarction. Lancet. 1975;1:415-419.Google ScholarCrossref 14. Mulcahy R, Graham I, Hickey N: Influence of cigarette smoking on morbidity, mortality, and mode of death in coronary patients, abstracted. Br Heart J. 1979;41:365.Google Scholar http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Early Discharge Following Acute Myocardial Infarction: Long-term Follow-up of Randomized Patients

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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1982.00340180031006
Publisher site
See Article on Publisher Site

Abstract

Abstract Long-term follow-up was obtained on 138 patients who participated in a prospective, randomized study comparing two weeks with three weeks of hospitalization following uncomplicated acute myocardial infarction. Follow-up information was available on 123 (89%) of all randomized patients. The mean follow-up period was 35 months for those patients who died and 99 months for those who survived. No differences were found between the two groups with respect to survival, cardiac-related deaths, frequency or severity of angina pectoris, subsequent myocardial infarction, incidence of congestive heart failure, number of ventricular aneurysms, or subsequent medical therapy. A significantly greater number of survivors in both groups stopped smoking and had a normal initial heart size than those who died. This long-term follow-up study further supports the conclusions of earlier short-term studies that two weeks of hospitalization is safe in patients with uncomplicated acute myocardial infarction. Back to top Article Information Reprint requests to Massachusetts General Hospital, Fruit Street, Boston, MA 02114 (Dr Hutter). This study was supported by Public Health Service grant HL17665. Theresa Flynn, RN, Aletha Roberts Niles, RN, and Kathy Donnick assisted in this investigation. References 1. Hutter AM Jr, Sidel VW, Shine KI, et al: Early hospital discharge after myocardial infarction. N Engl J Med. 1973;288:1141-1144.Google ScholarCrossref 2. McNeer JF, Wagner GS, Ginsburg PB, et al: Hospital discharge one week after acute myocardial infarction. N Engl J Med. 1978;298:229-232. PubMedGoogle ScholarCrossref 3. Harpur JE, Conner WT, Hamilton M, et al: Early mobilization and discharge from hospital in uncomplicated myocardial infarction. Lancet. 1971;2:1331-1334.Google ScholarCrossref 4. Harpur JE: Shorter hospitalization for myocardial infarcts. N Engl J Med. 1973;289:805.Google ScholarCrossref 5. Bloch A, Maeder J-P, Haissly J-C, et al: Early mobilization after myocardial infarction: A controlled study. Am J Cardiol. 1974;34:152-157. PubMedGoogle ScholarCrossref 6. Hayes MJ, Marris GK, Hampton JR: Comparison of mobilization after two and nine days in uncomplicated myocardial infarction. Br Med J. 1974;2:10-13. PubMedPubMedGoogle ScholarCrossref 7. Swan HJC, Blackburn HW, DeSanctis RW, et al: Duration of hospitalization in 'uncomplicated completed acute myocardial infarction': An ad hoc committee review. Am J Cardiol. 1976;37:413-419.Google ScholarCrossref 8. Abraham AS, Sever Y, Weinstein M, et al: Value of early ambulation in patients with and without complications after myocardial infarction. N Engl J Med. 1975;292:719-722. PubMedPubMedGoogle ScholarCrossref 9. McNeer JF, Wallace AG, Wagner GS, et al: The course of acute myocardial infarction: Feasibility of early discharge of the uncomplicated patient. Circulation. 1975;51:410-413. PubMedPubMedGoogle ScholarCrossref 10. Oberman A, Jones WB, Riley CP: Natural history of coronary artery disease. Bull NY Acad Med. 1972;48:1109-1125.Google Scholar 11. Slone D, Shapiro S, Rosenbert L, et al: Relation of cigarette smoking to myocardial infarction in young women. N Engl J Med. 1978;298:1273-1276. PubMedGoogle ScholarCrossref 12. Dall R, Peto R: Mortality in relation to smoking: 20 years' observations on male British doctors. Br Med J. 1976;2:1525-1536. PubMedGoogle ScholarCrossref 13. Wilhelmsson C, Elmfeldt D, Vedin JA, et al: Smoking and myocardial infarction. Lancet. 1975;1:415-419.Google ScholarCrossref 14. Mulcahy R, Graham I, Hickey N: Influence of cigarette smoking on morbidity, mortality, and mode of death in coronary patients, abstracted. Br Heart J. 1979;41:365.Google Scholar

Journal

Archives of Internal MedicineAmerican Medical Association

Published: May 1, 1982

References