Prognosis of patients > or = 70 years of age with non-Q-wave acute myocardial infarction compared with younger patients with similar infarcts and with patients > or = 70 years of age with Q-wave acute myocardial infarction.

In this study, 70 patients > or = 70 years of age admitted to the coronary care unit with non-Q-wave acute myocardial infarction (AMI) were followed prospectively for 1 year, and the clinical course in these patients was compared with that in 61 patients < 70 years with non-Q-wave AMI and 56 patients > or = 70 years with Q-wave AMI. Compared with the younger patients with non-Q-wave AMI, older patients were more likely to develop atrial fibrillation (23% vs 8%; p < 0.05) and congestive heart failure (53% vs 30%; p < 0.01), and less likely to receive thrombolytic therapy (9% vs 28%; p < 0.01), cardiac catheterization (41% vs 72%; p < 0.01), and coronary angioplasty (20% vs 39%; p < 0.05). Hospital mortality did not differ significantly between older and younger non-Q-wave AMI patients (10% vs 3%), but 1-year mortality was higher in the elderly (36% vs 16%; p = 0.02). Elderly patients with Q-wave AMI had more in-hospital complications, including death (25% vs 10%; p < 0.05), than elderly patients with non-Q-wave AMI. In contrast, postdischarge mortality was higher in elderly patients with non-Q-wave AMI, so that total mortality at 1 year was similar in the 2 groups. Overall, elderly patients with non-Q-wave AMI accounted for 62% of all deaths occurring during the first year after discharge (relative risk 2.6 compared with other groups; p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)