Original Article

Greater morbidity and mortality in acute myocardial in-farction is related to its occurrence in the elderly and in females, to a delay in hospital treatment, to the presence of diabetes mellitus, to impairment of the left ventricular ante-rior wall or involvement of the right ventricle, to the existen-ce of left ventricular dysfunction, and to the nonuse of coro-nary artery reperfusion therapy 1. In-hospital mortality in acute myocardial infarction, which was around 30 % in the 1950s, significantly declined during the past decades both in Europe and the United States (USA) 2, and also in several regions of Brazil 3, 4, the Northeastern region included 5. Currently, with the use of thrombolytic agents or of primary angioplasty, in-hospital mortality due to acute myocardial infarction is around 8 to 10%, mainly because of the benefits of early recanalization of the coronary artery related to the infarct 6. In the city of Fortaleza, in the Brazilian state of Ceará, the Hospital de Messejana of the State Secretariat of Health (HM-SESA, CE) is the major tertiary center for treating patients with acute myocardial infarction using the Sistema Único de Saúde (SUS the Brazilian public health system). At that hospital, from 1996 to 2000, mortality was above tha