PMID- 10078890
OWN - NLM
STAT- MEDLINE
DCOM- 19990325
LR  - 20190709
IS  - 0002-8614 (Print)
IS  - 0002-8614 (Linking)
VI  - 47
IP  - 3
DP  - 1999 Mar
TI  - Management and outcome of acute myocardial infarction in older patients in the 
      thrombolytic era.
PG  - 291-4
AB  - OBJECTIVE: Acute myocardial infarction (AMI) is an important cause of mortality 
      and morbidity in older patients. The aim of this study was to determine the 
      proportion of unselected admissions with AMI that is older than 75 years and to 
      examine management and outcomes in this group. DESIGN: An historical cohort study 
      of consecutive unselected admissions with AMI identified using the Hospital In 
      Patient Enquiry (HIPE) database and validated according to MONICA criteria for 
      definite or probable AMI. SETTING: An acute cardiac unit in a university teaching 
      hospital/cardiac tertiary referral center. RESULTS: Of 1059 patients, 606 (57%) 
      were older than 65 years and 309 (29.2%) were older than 75 years. Mean age in 
      this group was 80.5 years. Hospital mortality was almost twice as high as in 
      patients younger than 75 years (28% vs 15%, P < .001), and age was an independent 
      predictor of short- and long-term mortality following AMI. Women constituted a 
      significantly higher proportion of older patients. Family history of AMI and 
      cigarette smoking were less prevalent in older patients. Mean cholesterol was 
      lower and comorbidities were higher. Other baseline characteristics, including 
      previous AMI, did not differ. However older patients were less likely to receive 
      thrombolysis (13% vs 36%, P < .001), aspirin (76% vs 86%, P < .01), or 
      beta-blockers (25% vs 51%, P < .001) and were less likely to undergo cardiac 
      catheterization or revascularization. Only 53% were admitted to coronary care. 
      CONCLUSION: Patients more than age 75 comprise almost one-third of patients with 
      AMI and have a poor prognosis. Although age is an independent predictor of 
      mortality following AMI, suboptimal management may contribute to the high 
      mortality in these patients.
FAU - Mahon, N G
AU  - Mahon NG
AD  - Department of Clinical Cardiology, Mater Misericordiae Hospital, Dublin, Ireland.
FAU - Codd, M B
AU  - Codd MB
FAU - O'Rorke, C
AU  - O'Rorke C
FAU - Egan, B
AU  - Egan B
FAU - McCann, H A
AU  - McCann HA
FAU - Sugrue, D D
AU  - Sugrue DD
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Am Geriatr Soc
JT  - Journal of the American Geriatrics Society
JID - 7503062
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Platelet Aggregation Inhibitors)
SB  - IM
MH  - Adrenergic beta-Antagonists/therapeutic use
MH  - Age Factors
MH  - Aged
MH  - Cardiac Catheterization
MH  - Female
MH  - Fibrinolytic Agents/therapeutic use
MH  - Follow-Up Studies
MH  - *Hospital Mortality
MH  - Humans
MH  - Ireland
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/diagnosis/mortality/*therapy
MH  - Myocardial Revascularization
MH  - Patient Admission/*statistics & numerical data
MH  - Platelet Aggregation Inhibitors/therapeutic use
MH  - Practice Patterns, Physicians'/*statistics & numerical data
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Survival Analysis
MH  - Treatment Outcome
EDAT- 1999/03/17 00:00
MHDA- 1999/03/17 00:01
CRDT- 1999/03/17 00:00
PHST- 1999/03/17 00:00 [pubmed]
PHST- 1999/03/17 00:01 [medline]
PHST- 1999/03/17 00:00 [entrez]
AID - 10.1111/j.1532-5415.1999.tb02991.x [doi]
PST - ppublish
SO  - J Am Geriatr Soc. 1999 Mar;47(3):291-4. doi: 10.1111/j.1532-5415.1999.tb02991.x.