The Journal of

Introduction: Heart disease is the leading cause of death in the world. Acute Myocardial Infarction (AMI) is one of the most common cause of mortality causes in Iran. The purpose of this study is survey of the transition rates between heart disease stages and the effect of metabolic syndrome hazard on these transition rates by using a multi-state Markov model. Materials and Methods: 457 patients with heart disease which had admitted to the coronary care unit of Yazd hospitals in 2001 and 2002 were enrolled in the study and they were examined from their disease until 2006. Results: Estimated transition intensities suggest that in five years a patient in normal state with 26% probability will have symptomatic disease, with 11% probability will have advanced disease or with 24% probability be dead. Metabolic syndrome with HR=1.0598 indicates that the hazard of onset rate of heart disease for a person who is normally increases 6% and hazard of death for this person increases at the rate of 38% (HR=1.3778). Conclusion: When there are several outcomes, use of multi-state Markov model is recommended.