Document Detail


Geriatric patients with acute myocardial infarction: Cardiac risk factor profiles, presentation, thrombolysis, coronary interventions, and prognosis.
MedLine Citation:
PMID:  8721643     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Elderly patients have a higher mortality after acute myocardial infarction (MI) yet are treated less aggressively than younger patients. To determine (l) the risk-factor profiles, (2) presentation, (3) management, and (4) hospital outcomes for the elderly (> or = 75 years) compared with middle aged (66 to 74 years) and younger (< or = 65 years) patients in the 1990s, we studied 561 consecutive patients with acute MI. Compared with younger patients, the elderly more frequently had congestive heart failure (40 percent vs 14 percent; p < 0.00001) and non-Q wave infarctions (76 percent vs 56 percent; p < 0.005), received thrombolysis (9 percent vs 34 percent; p < 0.0001), and underwent catheterization (35 percent vs 73 percent; p < 0.00001), percutaneous transluminal coronary angioplasty (9 percent vs 31 percent; p < 0.0002), and coronary artery bypass grafting (5 percent vs 15 percent; p < 0.03) less frequently. Those who did not receive thrombolysis all had contraindications. Mortality was higher in the elderly (19 percent vs 5 percent; p < 0.004), especially among those who did not receive thrombolysis (20 percent vs 7 percent; p < 0.03). Multivariate predictors of mortality included age, and congestive heart failure. In addition, when clinical course and management variables were considered, use of the intraaortic balloon pump was a predictor of mortality, whereas undergoing coronary angiography was a negative predictor (relative risk, 0.3; 95 percent confidence intervals, 0.1 to 0.6).
Authors:
S D Paul; P T O'Gara; Z A Mahjoub; T G DiSalvo; C J O'Donnell; J B Newell; G Villarreal-Levy; A J Smith; N I Kondo; M Cararach; L Ferrer; K A Eagle
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  131     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1996 Apr 
Date Detail:
Created Date:  1996-09-23     Completed Date:  1996-09-23     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  710-5     Citation Subset:  AIM; IM    
Affiliation:
Cardiac Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Angioplasty, Transluminal, Percutaneous Coronary
Coronary Angiography
Coronary Artery Bypass
Diagnosis, Differential
Electrocardiography
Female
Heart Failure / etiology
Humans
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction* / complications,  diagnosis,  etiology,  mortality,  therapy
Prognosis
Risk Factors
Thrombolytic Therapy
Treatment Outcome

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


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