Living alone and atypical clinical presentation are associated with higher mortality in patients with all components of the acute coronary syndrome.

Background: Most prognostic studies of the acute coronary syndrome (ACS) have been performed in patients selected for inclusion into clinical trials. We stratified the risk of death during the year after hospitalization for a first episode of ACS in unselected patients based on clinical and socio-economic information.

Methods: In 2000-2002 we identified 457 consecutive unselected patients admitted to hospital with a first episode of ACS. Vital status was obtained from Danish national registers.

Results: The 1-year case-fatality proportion was 9.8%. Positive predictors of mortality were living alone, Q waves and diabetes. Negative predictors were chest pain, ST elevation and treatment with angioplasty or thrombolysis.