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[Prognosis of acute myocardial infarction in the elderly. SPRINT Study Group]
D Gilat1, U Goldbourt, H Reicher-Reiss
1Neufeld Cardiac Research Institute, Chaim Sheba Medical Center, Tel Hashomer.
Insights
Acute myocardial infarction (MI) in elderly patients over 75 shows high mortality. Thrombolysis is recommended for these high-risk patients when no contraindications exist.
Area of Science:
- Cardiology
- Geriatric Medicine
- Public Health
Context:
- Aging populations globally are experiencing a rapid increase in acute myocardial infarction (MI) cases among the elderly.
- Hospital and long-term mortality rates following MI remain significantly high in this demographic.
- A study in Israel (1981-83) analyzed 653 patients over 75 years old with acute MI.
Purpose:
- To assess the in-hospital and long-term outcomes of acute myocardial infarction (MI) in patients over 75 years old.
- To evaluate the high mortality rates associated with acute MI in the very elderly population.
- To determine the potential benefit of thrombolysis in reducing mortality for elderly MI patients.
Summary:
- Among 653 patients over 75 hospitalized for acute MI, 11% of all MI patients, in-hospital mortality was 35%.
- One-year post-discharge mortality was 24%, and five-year mortality reached 55%.
- The study highlights the critical need for effective interventions in this vulnerable group.
Impact:
- The findings underscore the significant risk and poor prognosis for elderly patients experiencing acute MI.
- Results suggest that thrombolysis, showing promise in the elderly, should be routinely considered for acute MI patients over 75, barring contraindications.
- This research informs clinical practice guidelines for managing acute MI in geriatric populations.
Abstract:
In countries with aging populations acute myocardial infarction (MI) in the elderly is increasing rapidly and hospital and long-term mortality remain high. During 1981-83, 5839 consecutive patients with acute MI were hospitalized in 13 coronary care units in Israel. Of these, 653 (11%) were older than 75 years, 41% were women, and 70% had a first MI. The hospital mortality in these very elderly patients was 35%. The mortality rates 1 and 5 years postdischarge were 24% and 55%, respectively. In view of this high risk and the promising results obtained elsewhere with thrombolysis, particularly in the elderly, this treatment should be routinely considered in elderly patients with acute MI when there are no specific contraindications.