Mortality and morbidity during one year of follow-up in suspected acute myocardial infarction in relation to early diagnosis: experiences from the MIAMI trial

J Intern Med. 1990 Aug;228(2):125-31. doi: 10.1111/j.1365-2796.1990.tb00205.x.


From a large randomized multicentre trial of metoprolol in suspected acute myocardial infarction (n = 5778) we report on the outcome during 1 year of follow-up, in relation to early diagnosis. Patients who developed a confirmed infarction had a 1-year mortality rate of 12.8%. This was significantly higher than the mortality rate of 6.3% (P less than 0.001) in patients with possible infarction and it was also higher than that in patients with no infarction, which was 5.0% (P less than 0.001). A multivariate analysis showed that independent risk predictors in the clinical history of patients without confirmed infarction were a history of angina pectoris, chronic use of digitalis and advanced age. After 1 year, angina pectoris was most common in patients with an initial possible infarction. These patients were also in most urgent need of bypass surgery. We thus conclude that the mortality during 1 year of follow-up among patients with an initially strongly suspected acute myocardial infarction was clearly related to whether or not the patient developed a myocardial infarction.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angina Pectoris / epidemiology
  • Double-Blind Method
  • Electrocardiography
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Metoprolol / therapeutic use
  • Middle Aged
  • Multicenter Studies as Topic
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / drug therapy
  • Myocardial Infarction / mortality*
  • Randomized Controlled Trials as Topic
  • Recurrence
  • Risk Factors
  • Survival Rate


  • Metoprolol