The aim of this paper was to study the long term evolution of patients (one to five years) after an acute myocardial infarction. Three hundred and twenty questionnaires were sent to patients admitted and diagnosed as acute myocardial infarction in the private sector of the Instituto Nacional de Cardiología "Ignacio Chávez". One hundred seventy five useful answers were obtained. Of these patients, coronariography was performed in 132 during the acute episode. In 57 CABG was performed. Most of them had three vessels or main left coronary artery occlusions. In the late long term evolution 68 patients had angor pectoris, 16 had unstable angina, more advanced lesions were found in 14 of them in a new angiographic study. In nine CABG was performed, three were treated with angioplasty, in two there was no indication for intervention. One had a new myocardial infarction and one died. Only four patients had a new myocardial infarction, two of them died, and another one had heart failure. In three of them a new angiographic study showed significant occlusion of the main left coronary artery. Eight patients died between the second and fourth year of evolution, in two it was a sudden death, two had a new myocardial infarction, three had heart failure and in one the cause of death was a stroke. Ten patients died during the first year of evolution the main cause was sudden death.(ABSTRACT TRUNCATED AT 250 WORDS)