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OBJECTIVE Analysing the influence of clinical and paraclinical "markers" in long term prognosis (LTP) of Acute Myocardial Infarction (AMI), in terms of mortality, post AMI Angina, post AMI Heart Failure and non fatal recurrent AMI in patients of a Post AMI Consultation of a peripherical hospital. METHODS A) Retrospective study (series A and B) of the average incidence of 17 "markers" of bad post AMI TLP so as to identify those that had a discriminating value with regards to death after hospital discharge. B) Prospective study so as to determine its influence in those patients followed in a post AMI Consultation (series C), with regards to mortality, post AMI Angina, post AMI Heart Failure and non fatal recurrent AMI. METHODS Series A - 97 survivors of AMI treated on the CCU of Madeira's Hospital Center in its 1st year. Series B - 91 survivors of AMI treated of AMI treated on the CCU of Madeira's Hospital Center in its 2nd year. Series C - 88 survivors of AMI treated on the CCU of Madeira's Hospital Center after this period and followed up since then at the post AMI consultation. RESULTS A) Significant statistical differences were observed in the series A and B, with regards to late mortality, in 5 of those "markers" (aged greater than or equal to 70 years, Auricular Fibrillation and Killip III class during the acute phase of the AMI, frequent ectopic ventricular beats before discharge and a survival probability of less than or equal to 60% at 5 years after AMI). B) It was observed that bearers of greater than or equal to 1 of these 5 clinical "markers" of the series C had significant statistical differences in relation to non bearers with regards to mortality, post AMI Angina, post AMI Heart Failure and non fatal recurrent AMI. CONCLUSIONS It is considered that those 5 post AMI clinical "markers" allows identification of the very bad cases of post AMI LTP in peripherical hospitals. This identification can lower the ratio cost benefit of the indispensable diagnostic techniques for stratification of post AMI risk, through the rationalization of its use. A Study of its accessibility with regards to peripherical hospitals and a AMI national register became important to evaluate the problem of the Portuguese AMI survivors in terms of Public Health.
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