Document Detail


Are coronary-care unit changes in therapy associated with improved survival of elderly patients with acute myocardial infarction?
MedLine Citation:
PMID:  9374974     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether changes in coronary-care unit therapy for elderly patients with acute myocardial infarction have been associated with improved survival.
MATERIAL AND METHODS: We conducted a retrospective cohort analysis of all patients 70 years of age or older from Olmsted County, Minnesota, who were hospitalized in a coronary-care unit in this county for the treatment of acute myocardial infarction during one of three periods: 1976 through 1978, 1987 through 1989, and 1991. The effect of aspirin, heparin, beta-blockers, thrombolysis, percutaneous transluminal coronary angioplasty, and coronary artery bypass grafting on these elderly patients with acute myocardial infarction was assessed.
RESULTS: Improvement in 30-day survival was significant for patients 80 years of age or older (45%, 69%, and 78% in 1976 through 1978, 1987 through 1989, and 1991, respectively; P = 0.01 for the trend) but not for patients 70 to 79 years of age (77%, 76%, and 81% for the three time periods, respectively; P = 0.65 for the trend). The opposite pattern was observed for survival in the period more than 30 days after the event. More intensive treatment in the hospital was associated with better 30-day survival (P < 0.0001).
CONCLUSION: The improved survival of the elderly patients with acute myocardial infarction in these cohorts can be accounted for by changes in the therapy they received in the coronary-care units.
Authors:
H Daida; T E Kottke; R J Backes; B J Gersh; E G Tangalos; K R Bailey
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Mayo Clinic proceedings     Volume:  72     ISSN:  0025-6196     ISO Abbreviation:  Mayo Clin. Proc.     Publication Date:  1997 Nov 
Date Detail:
Created Date:  1997-12-11     Completed Date:  1997-12-11     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  0405543     Medline TA:  Mayo Clin Proc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1014-21     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Aged, 80 and over
Angioplasty, Balloon, Coronary
Cardiac Catheterization
Coronary Angiography
Coronary Artery Bypass
Coronary Care Units
Female
Humans
Male
Myocardial Infarction / diagnosis,  drug therapy,  mortality,  surgery,  therapy*
Proportional Hazards Models
Retrospective Studies
Severity of Illness Index
Survival Analysis
Treatment Outcome
Grant Support
ID/Acronym/Agency:
AR 30582/AR/NIAMS NIH HHS; HL 24326/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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