D Fernández-Bergés1, F J Félix-Redondo2, L Consuegra-Sánchez3, L Lozano-Mera4, I Miranda Díaz5, M Durán Guerrero6, F Benítez de Castro6, J B Polanco García6, J R López-Mínguez7. 1. Sección de Cardiología, Departamento de Medicina Interna, Hospital Don Benito-Villanueva, Don Benito, Badajoz, España; Unidad de Investigación Programa de Investigación en Enfermedades Cardiovasculares PERICLES, Villanueva de la Serena, Badajoz, España. Electronic address: polonibo@gmail.com. 2. Unidad de Investigación Programa de Investigación en Enfermedades Cardiovasculares PERICLES, Villanueva de la Serena, Badajoz, España; Centro de Salud Villanueva de la Serena Norte, Villanueva de la Serena, Badajoz, España. 3. Servicio de Cardiología, Hospital Universitario de Santa Lucia, Cartagena, Murcia, España. 4. Unidad de Investigación Programa de Investigación en Enfermedades Cardiovasculares PERICLES, Villanueva de la Serena, Badajoz, España; Centro de Salud Mérida Urbano, Mérida, Badajoz, España. 5. Unidad de Investigación Programa de Investigación en Enfermedades Cardiovasculares PERICLES, Villanueva de la Serena, Badajoz, España. 6. Sección de Cardiología, Departamento de Medicina Interna, Hospital Don Benito-Villanueva, Don Benito, Badajoz, España. 7. Servicio de Hemodinámica, Hospital Universitario Infanta Cristina, Badajoz, España.
Abstract
OBJECTIVES: Elderly patients with acute myocardial infarction constitute a population that is not adequately represented in clinical trials or medical registries. Our objective was to compare the clinical characteristics, treatments administered and mortality among patients younger and older than 75 years. MATERIAL AND METHODS: Observational retrospective study of patients hospitalized for acute myocardial infarction in the decade 2000-2009. Multivariate models were constructed to determine hospital and late mortality (median, 4.6 years; IQR 25-75: 2.1-7.3). RESULTS: We included 2,177 patients (995 men [79%]), with a mean age of 70.8 years (SD, 12.6). A total of 917 (42.0%) of the patients were 75 years of age or older. When compared with the patients younger than 75 years, the older patients had a greater prevalence of diabetes (38.3% vs. 32.5%; P<.002), chronic obstructive pulmonary disease (15.6% vs. 11.2%; P<.002), stroke (14.3% vs. 7.3%; P<.001), chronic renal failure (11.0% vs. 3.9%; P<.001), atrial fibrillation (15.9% vs. 6.9%; P<.001), heart failure (28.0% vs. 23.4%; P<.008). The older patients were treated with fewer beta-blockers (55.9% vs. 71.2%; P<.001), statins (44.3% vs. 62.3%; P<.001), coronary angiographies (17.9% vs. 48.5%; P<.001) and angioplasties (10.8% vs. 29.1%; P<.001). The patients older than 75 years had lower survival (mortality, 44.5% vs. 18.9%; HR 1.89; 95% CI 1.57-2.29). The use of beta-blockers (HR, 0.74; 95% CI 0.62-0.89), statins (HR 0.73; 95% CI 0.58-0.91) and angioplasty (HR, 0.42; 95% CI 0.30-0.57) was inversely correlated with mortality. CONCLUSIONS: Patients older than 75 years with acute myocardial infarction had lower survival and were treated with fewer beta-blockers, statins and angioplasty, indications that are associated with lower mortality.
OBJECTIVES: Elderly patients with acute myocardial infarction constitute a population that is not adequately represented in clinical trials or medical registries. Our objective was to compare the clinical characteristics, treatments administered and mortality among patients younger and older than 75 years. MATERIAL AND METHODS: Observational retrospective study of patients hospitalized for acute myocardial infarction in the decade 2000-2009. Multivariate models were constructed to determine hospital and late mortality (median, 4.6 years; IQR 25-75: 2.1-7.3). RESULTS: We included 2,177 patients (995 men [79%]), with a mean age of 70.8 years (SD, 12.6). A total of 917 (42.0%) of the patients were 75 years of age or older. When compared with the patients younger than 75 years, the older patients had a greater prevalence of diabetes (38.3% vs. 32.5%; P<.002), chronic obstructive pulmonary disease (15.6% vs. 11.2%; P<.002), stroke (14.3% vs. 7.3%; P<.001), chronic renal failure (11.0% vs. 3.9%; P<.001), atrial fibrillation (15.9% vs. 6.9%; P<.001), heart failure (28.0% vs. 23.4%; P<.008). The older patients were treated with fewer beta-blockers (55.9% vs. 71.2%; P<.001), statins (44.3% vs. 62.3%; P<.001), coronary angiographies (17.9% vs. 48.5%; P<.001) and angioplasties (10.8% vs. 29.1%; P<.001). The patients older than 75 years had lower survival (mortality, 44.5% vs. 18.9%; HR 1.89; 95% CI 1.57-2.29). The use of beta-blockers (HR, 0.74; 95% CI 0.62-0.89), statins (HR 0.73; 95% CI 0.58-0.91) and angioplasty (HR, 0.42; 95% CI 0.30-0.57) was inversely correlated with mortality. CONCLUSIONS:Patients older than 75 years with acute myocardial infarction had lower survival and were treated with fewer beta-blockers, statins and angioplasty, indications that are associated with lower mortality.
Authors: Francisco Javier Félix-Redondo; Luis Lozano Mera; Luciano Consuegra-Sánchez; Fernando Giménez Sáez; Francisco Javier Garcipérez de Vargas; José María Castellano Vázquez; Daniel Fernández-Bergés Journal: Open Heart Date: 2016-02-26
Authors: Daniel Fernández-Bergés; Irene R Degano; Reyes Gonzalez Fernandez; Isaac Subirana; Joan Vila; Manuel Jiménez-Navarro; Silvia Perez-Fernandez; Mercé Roqué; Antoni Bayes-Genis; Francisco Fernandez-Aviles; Antonio Mayorga; Vicente Bertomeu-Gonzalez; Juan Sanchis; Marcos Rodríguez Esteban; Antonio Sanchez-Hidalgo; Esther Sanchez-Insa; Ane Elorriaga; Emad Abu Assi; Alberto Nuñez; Jose Manuel Garcia Ruiz; Pedro Morrondo Valdeolmillos; Daniel Bosch-Portell; Iñaki Lekuona; Andres Carrillo-Lopez; Alberto Zamora; Berta Vega-Hernandez; Javier Alameda Serrano; Catalina Rubert; Luis Ruiz-Valdepeñas; Laura Quintas; Luis Rodríguez-Padial; Jessica Vaquero; Luis Martinez Dolz; Jose A Barrabes; Pedro L Sanchez; Alessandro Sionis; Julio Martí-Almor; Roberto Elosua; Rosa-María Lidon; David Garcia-Dorado; Jaume Marrugat Journal: Open Heart Date: 2020-08