Author + information
- Received June 27, 1983
- Revision received November 15, 1983
- Accepted November 28, 1983
- Published online May 1, 1984.
- Sidney Goldstein, MD, FACC*,1,
- Lawrence Friedman, MD1,
- Richard Hutchinson, MD, FACC1,
- Paul Canner, PhD1,
- Donald Romhilt, MD, FACC1,
- Robert Schlant, MD, FACC1,
- Rafael Sobrino, MD, FACC1,
- Joel Verter, PhD1,
- Alan Wasserman, MD, FACC1,
- Aspirin Myocardial Infarction Study Research Group1
- ↵*Address for reprints: Sidney Goldstein, MD, Division of Cardiovascular Medicine, Henry Ford Hospital, 2799 W. Grand Boulevard. Detroit, Michigan 48202.
The temporal distribution and mechanism of death were studied in a large multicenter secondary prevention trial (Aspirin Myocardial Infarction Study) in which acute witnessed death represented 72% (270 of 376) of the deaths due to arteriosclerotic heart disease. Instantaneous deaths represented 28.9% (78 of 270) of the acute witnessed deaths; 45.2% (122 of 270) occurred in the first hour after the onset of symptoms and were defined as sudden deaths. In the subsequent 23 hours, an additional 113 deaths (41.8%) occurred and were defined as intermediate deaths; 29 late deaths (10.7%) occurred after 24 hours. Cardiac arrhythmia was the mechanism of death in 83% (194 of 235) of deaths within 24 hours. Univariate analysis of baseline clinical and electrocardiographic characteristics indicates that a history of congestive heart failure, cardiomegaly, angina pectoris, multiple myocardial infarctions and therapy with digitalis and nitroglycerin were more common in those who died than in survivors, regardless of the timing of death.
- Received June 27, 1983.
- Revision received November 15, 1983.
- Accepted November 28, 1983.
- American College of Cardiology Foundation