Long-term prognosis was evaluated in 416 myocardial infarction (MI) patients, 339 males and 77 females, admitted to our department between November, 1979 and April, 1992. Twenty patients died in the hospital, 75 died after discharge, 61 required percutaneous transluminal coronary angioplasty or aortocoronary bypass graft, and 4 were lost to follow-up. The cause of death after discharge was reinfarction in 15 patients, heart failure or sudden death in 27 and non-cardiac in 33. Non-survivors were older than survivors, and left ventricular end-diastolic dimension was greater, coronary lesions were more severe and a history of reinfarction was more common in the non-survivors. Among the survivors, serum total and LDL cholesterol levels were higher and coronary lesions were more severe in patients whose condition became worse. Quality of life was most significantly affected by the presence of chest pain. The five-year survival after discharge was 82.5% overall, 90.4% in zero or single vessel disease and 84.3% in multivessel disease.