[Severe heart insufficiency after acute myocardial infarct: follow up].

An attempt is made to identify and establish the prognostic significance of a subset of patients at high risk after myocardial infarction in need of different therapeutic interventions, using clinical variables of a recently published prospective postinfarction follow-up study. The survivors with anterior myocardial infarction, severe left ventricular dysfunction and ventricular premature depolarizations, making up 15% of the population, have the greatest potential for mortality reduction by appropriate intervention after infarction. The dominance of mechanical and electrical factors in the high risk group necessitates a combined therapeutic approach. The rapid decline in the survivorship curve, with a rapid decline during the first 6 months of the posthospital period implies different intervention regimes at different chronologic intervals in the convalescence phase after myocardial infarction.