BACKGROUND: The progressive aging of society results in increased numbers of acute myocardial infarctions (MI) in the elderly. In the presence of huge progress in MI treatment, it seems to be reasonable to analyse clinical course and prognosis in the elderly with MI. AIM: To assess differences in clinical characteristics and treatment of MI between patients younger than 65 and the elderly. METHODS: A total of 491 patients over 65 and 398 patients younger than 65 with acute MI between June 2005 and February 2006 were retrospectively analysed. RESULTS: In patients over 65 there was significantly higher prevalence of arterial hypertension and diabetes, as well as low left ventricular ejection fraction and advanced heart failure. The time from onset of symptoms to admission was longer in the older group. The rate of reperfusion therapy in the elderly was significantly lower, and the results of invasive treatment were poor. Antiplatelet treatment was less aggressive in this group. In-hospital and long-term mortality were significantly higher in patients over 65, but the lowest in subjects undergoing invasive strategy. CONCLUSIONS: Risk factors in baseline characteristics and lower rate of invasive therapeutic strategy result in worse prognosis in patients over 65 with acute MI. A significant reduction in mortality due to the invasive approach should encourage wide implementation of this approach in the elderly.
BACKGROUND: The progressive aging of society results in increased numbers of acute myocardial infarctions (MI) in the elderly. In the presence of huge progress in MI treatment, it seems to be reasonable to analyse clinical course and prognosis in the elderly with MI. AIM: To assess differences in clinical characteristics and treatment of MI between patients younger than 65 and the elderly. METHODS: A total of 491 patients over 65 and 398 patients younger than 65 with acute MI between June 2005 and February 2006 were retrospectively analysed. RESULTS: In patients over 65 there was significantly higher prevalence of arterial hypertension and diabetes, as well as low left ventricular ejection fraction and advanced heart failure. The time from onset of symptoms to admission was longer in the older group. The rate of reperfusion therapy in the elderly was significantly lower, and the results of invasive treatment were poor. Antiplatelet treatment was less aggressive in this group. In-hospital and long-term mortality were significantly higher in patients over 65, but the lowest in subjects undergoing invasive strategy. CONCLUSIONS: Risk factors in baseline characteristics and lower rate of invasive therapeutic strategy result in worse prognosis in patients over 65 with acute MI. A significant reduction in mortality due to the invasive approach should encourage wide implementation of this approach in the elderly.
Authors: Petr Widimsky; William Wijns; Jean Fajadet; Mark de Belder; Jiri Knot; Lars Aaberge; George Andrikopoulos; Jose Antonio Baz; Amadeo Betriu; Marc Claeys; Nicholas Danchin; Slaveyko Djambazov; Paul Erne; Juha Hartikainen; Kurt Huber; Petr Kala; Milka Klinceva; Steen Dalby Kristensen; Peter Ludman; Josephina Mauri Ferre; Bela Merkely; Davor Milicic; Joao Morais; Marko Noc; Grzegorz Opolski; Miodrag Ostojic; Dragana Radovanovic; Stefano De Servi; Ulf Stenestrand; Martin Studencan; Marco Tubaro; Zorana Vasiljevic; Franz Weidinger; Adam Witkowski; Uwe Zeymer Journal: Eur Heart J Date: 2009-11-19 Impact factor: 29.983
Authors: Wojciech Drewniak; Wojciech Szybka; Dariusz Bielecki; Michal Malinowski; Joanna Kotlarska; Agnieszka Krol-Jaskulska; Agata Popielarz-Grygalewicz; Aleksandra Konwicka; Marek Dąbrowski Journal: Biomed Res Int Date: 2015-10-11 Impact factor: 3.411