CORONARY HEART-DISEASE IN RESIDENTS OF ROCHESTER, MINNESOTA .5. PROGNOSIS OF PATIENTS WITH CORONARY HEART-DISEASE BASED ON INITIAL MANIFESTATION

During the period 1960 through 1979, 1014 residents of Rochester, Minnesota, had a diagnosis of classic angina pectoris as the 1st manifestation of coronary heart disease, and 1013 had a myocardial infarction as the initial manifestation. In the angina cohort, about 50% were men, and of them, 20% were 70 yr old or older. The female patients were an average of 6 yr older than the men, and 43% were 70 yr old or older. In this cohort, the 5 yr survival rate increased from 77% in the 1960s to 87% in the 1970s (P < 0.01). The 5 yr net survivorship free of a myocardial infarction increased from 76-85% during that same time (P < 0.01). In the myocardial infarction cohort, the 5 yr death rate among the 30 day survivors of myocardial infarction was the same during both decades of the study. The age-adjusted reinfarction rate/100 person-yr at risk during the first 5 yr of follow-up decreased very slightly among men and increased among women; thus, it remained essentially unchanged overall. Although the case fatality rate in the myocardial infarction cohort declined sharply from the 1960s to the 1970s, the long-term prognosis of the 30 day survivors of a myocardial infarction did not improve.