IHD has far-reaching consequences

A heart attack can lead to arrhythmias, that may be lethal, and heart failure due to loss of viable myocardial tissue. Heart failure is related to a poor prognosis. IHD is also related to angina pectoris(see Definition and scope). When patients experience severe complaints, an operation can be performed on the coronary arteries (coronary by-pass surgery) or the obstructed vessel may be dilated by means of a percutaneous intervention can be carried out (Percutaneous Transluminal Coronary Angioplasty). Continuing symptoms can result in a patient being limited in his/her physical activities and being forced to give up employment. Some patients develop depressions or anxieties, disorders that cannot always be identified.

High death toll from acute heart attack

According to the Euro Heart Survey 2001, 11% of patients admitted to hospital with an acute infarction die within 30 days. For patients with unstable angina pectoris this figure is 2% (Hasdai et al., 2002). Patients diagnosed with (stable) angina pectoris have a much better prognosis. Only 2 to 3% of these patients suffer from serious complications such as death or an acute heart attack per year (Daly et al., 2006).

See the table on rates of coronary events and case-fatality in 13 European countries which shows the case-fatality as recorded in the MONICA project for all coronary events, thus including deaths occurring before arrival in the hospital. These case-fatality rates shown in this table range from 35% in Northern Sweden and Iceland to over 80% in the Polish region of Tarnobrzeg.

Prognosis for coronary heart disease has improved over time

The prognosis for coronary heart disease has improved in the past decades. The two-year death rates for Swedish patients with unstable angina pectoris, for example, dropped from 30% in 1988 to 19% in 1995 (Abrahamsson et al., 2000). Research in the United States has shown that a positive outcome is now more common for heart attack patients (Hellermann et al., 2002).