The long-term outcome of patients who suffered and survived an acute myocardial infarction in the midst of recurrent attacks of variant angina.

Twenty-one patients, ranging in age between 28 and 59 years, who survived hospitalization for an acute myocardial infarction in association with repetitive attacks of variant angina, were followed prospectively for 59.1 +/- 5.1 (SEM) (range 17-120) months. Four patients died, one of sudden death 17 months after admission, one of congestive heart failure at 33 months, and two of cancer at 43 and 45 months of follow-up. Three patients had four new myocardial infarctions at 22, 32, 33, and 61 months of follow-up. Six patients were readmitted for angina or other cardiac reasons. Twelve patients remained asymptomatic throughout the follow-up and one more patient was asymptomatic before and after his recurrent myocardial infarction. No relapse of variant angina was documented. Thus, the long-term course of patients with variant angina culminating in acute myocardial infarction is relatively benign, despite the highly unstable features of their initial presentation.