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The acute myocardial infarction in very elderly
Aliberti1, Pulignano, Proietta
1Dipartimento di Scienze Cliniche, Universitá di Roma 'La Sapienza', Policlinico Umberto I, Viale del Policlinico, 00161, Rome, Italy
Insights
Very elderly patients with myocardial infarction show distinct biochemical markers, including higher fibrinogen and LDH, and lower hemoglobin, suggesting delayed hospitalization and contributing to poorer prognosis.
Area of Science:
- Cardiology
- Geriatric Medicine
- Clinical Biochemistry
Background:
- Elderly patients exhibit higher mortality rates following myocardial infarction.
- Understanding the physiological and biochemical differences in this demographic is crucial.
Purpose of the Study:
- To investigate biochemical markers in elderly patients admitted for myocardial infarction.
- To identify factors contributing to the excess mortality observed in very elderly patients.
Main Methods:
- Studied 325 patients at myocardial infarction admission.
- Measured plasma fibrinogen (FBG), creatine phosphokinase (CPK), lactate dehydrogenase (LDH), and hemocitometric parameters.
- Compared biochemical profiles across different age subgroups (≤65, 66-75, >75 years).
Main Results:
- Age correlated positively with fibrinogen and LDH, and inversely with CPK, hemoglobin, and lymphocyte count.
- Patients over 75 years showed significantly higher FBG, neutrophil count, and LDH compared to younger groups.
- Very elderly patients had lower hemoglobin, red blood cell count, hematocrit, and lymphocyte count.
Conclusions:
- Biochemical profiles in very elderly myocardial infarction patients suggest delayed hospitalization.
- These altered biochemical features may contribute to the poorer prognosis observed in this population.
- Further research into optimizing care pathways for elderly MI patients is warranted.
Abstract:
A total 325 patients were studied at admission for myocardial infarction, measuring plasma fibrinogen (FBG), creatine phosphokinase (CPK) and lactate dehydrogenase (LDH) and automatized hemocromocytometric parameters in order to contribute to explain the excess mortality reported in very elderly patients. It was found that age positively correlated with fibrinogen and LDH values and inversely with CPK, hemoglobin concentration and lymphocyte count. The unpaired comparison of the variables studied in age subgroups showed no differences between patients aged 65 or less than 65 years and patients aged 66-75 years. In patients aged over 75 years FBG, neutrophile count and LDH were significantly higher in respect to 65 or less and 66-75 years age subgroups and hemoglobin concentration, red blood cell count, hematocrit and lymphocyte count were lower. In the very elderly patients the study shows a biochemical feature suggesting delayed hospitalization for myocardial infarction, that may contribute to their poorer prognosis.