[Advanced age as a risk factor for heart failure after acute myocardial infarction]

Heart failure (HF) is one of the most unfavorable consequences of the acute myocardial infarction (AMI), resulting in increased hospitalization level and mortality. The patients of advanced age constitute the major part among patients with HF due to AMI. In 123 patients a number of variables of the acute phase were investigated as potential predictors of developing HF within 12 months after AMI and the role of age was assessed. The relation of HF, echocardiographic variables measured 12 months after infarction and age was also studied. On completion a one-year follow-up, 54 patients (44%) developed HF, mainly of 2nd NYHA class. The age of the patients was the only independent predictor of HF among the variables of the acute phase (OR = 1.06 under 95% CI (1.01-1.12). The age over 65 years demonstrated 78% sensitivity and specificity in predicting development of HF. Among parameters estimated at the end of 12-months follow-up, age (OR = 0.934 under 95% CI (0.889-0.983) and echocardiographic wall motion score index (WMSI) (OR = 0.031 under 95% CI (0.003-0.333) independently influenced the presence of HF The factor of age had decisive importance for HF development in group of the patients with medium infarct size. At WMSI range 1.6-1.89, 11 of 20 patients younger than 65 had no HF, whereas 8 of 9 patients older than 65 developed HF (p < 0.05). Thus, age is a major independent predictor of development of HF within the first year after AMI. The patients of the senior age group 65+) have a high risk of HF with medium infarct size, which does not result in HF in patients of younger age.