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Acute Cardiogenic Pulmonary Edema (12)

Another variable that reflects the influence of hemodynamic insufficiency on mortality is the presence of acute anterior myocardial infarction. We observed a mortality of 63.3 percent among patients who had anterior myocardial infarction and 22.4 percent among those who did not, results that are similar to the 52.9 percent and 13.5 percent mortality among patients with and without myocardial infarction reported by Weiner et al. The multivariate analysis we performed clarifies the relationship among myocardial infarction, hypotension, and death. It indicates that hypotension and anterior myocardial infarction have independent significance, with systolic blood pressure being more than twice as important (Table 4).
The use of calcium channel blockers was associated with increased mortality in both univariate and multiple regression analysis. This variable had independent predictive value and did not interact with other terms in the logistic regression model, nor was its predictive value dependent on interaction with the covariates of p-blockers use, prior myocardial infarction, angina, or congestive heart failure. The diltiazem postinfarction research group found a higher mortality among those given diltiazem in the subset of 490 patients who had left ventricular dysfunction.

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