[Myocardial infarct in the geriatric patient: the short- and mid-term prognostic factors]

The purpose of this study was to investigate the clinical features and the prognostic factors related to early and late mortality in the acute myocardial infarction (AMI) in the geriatric population. We have studied 208 consecutive patients with AMI admitted to the Coronary Care Unit at the Hospital General de Asturias. Two groups were selected: group A included 102 patients older than 65 years; and 106 were younger (group B). In the group A was found a significantly lower percentage of males (52.9% vs 89.6%; p less than 0.0001) and smokers (45.1% vs 89.6%; p less than 0.0001); and older patients showed a greater incidence of diabetes mellitus (30.7% vs 16%; p less than 0.01). In the geriatric group, the clinical course of AMI is characterized by a greater incidence of heart failure (50% vs 29.2%; p less than 0.002) and cardiogenic shock (22.5% vs 7.5%; p = 0.002). Early mortality (first month) was significantly higher in elderly patients (36.3% vs 7.5%; p less than 0.001); and this increased mortality rate is partially related to an increased incidence of heart pump failure, despite having a smaller enzymatic infarct size by CPK peak (1,062 +/- 1,017 U/l vs 1,579 +/- 1,428 U/l; p less than 0.005). The multivariate analysis by stepwise logistic regression, selected diabetes mellitus, heart failure and peri-infarct bundle branch blocks as the only independent predictive variables for the early mortality.(ABSTRACT TRUNCATED AT 250 WORDS)