Occurrence of Chest Pain More than 24 Hours after Hospital Admission in Acute Myocardial Infarction and Its Relation to Prognosis

In 857 consecutive patients with acute myocardial infarction (AMI), the occurrence of chest pain more than 24 h after hospital admission is described and related to death or reinfarction during one year of follow-up. Prolonged chest pain was observed in 333 patients (39%). In this group 15% died and 7% developed reinfarction during the first month as compared with 10% (p < 0.05) and 2% (p < 0.01) respectively in patients without prolonged pain. However, during one year of follow-up mortality did not differ significantly between patients with (27%) and without (24%) prolonged pain. The 1-year reinfarction rate was similar in the two groups (18% and 14%, respectively; NS). We conclude that AMI patients with prolonged chest pain have a particularly high mortality during the first month. However, during a longer follow-up the prognosis is similar in patients with and without prolonged chest pain.