[Clinical and prognostic implications of age in acute myocardial infarct].
The purpose of this study was to evaluate the clinical characteristics and the factors related to early mortality in the acute myocardial infarction of the geriatric population. We studied 814 consecutive patients with their first acute myocardial infarction admitted to the coronary care unit at tha Hospital General de Galicia. 401 patients were older than 65 years (Group A) and 413 were younger (Group B). Group A was found a significantly lower percentage of males (64.7% versus 88.4%; p less than 0.001) and smokers (46.7% versus 72.7%; p less than 0.001; and older patients showed a greater incidence of diabetes mellitus (28.1% versus 15.2%; p less than 0.001) and arterial hypertension (45.6% versus 31.7%; p less than 0.01). In the geriatric population, the clinical course of the acute myocardial infarction is characterized by a greater incidence of heart failure (35.3% versus 11.1%; p less than 0.001), cardiogenic shock (18% versus 5.7%; p less than 0.001) and post-acute myocardial infarction angina pectoris (18.3% versus 12.2%; p less than 0.05). Early mortality (first month) was significantly higher in elderly patients (22.7% versus 6.3%; p less than 0.001). The multivariate analysis by stepwise logistic regression identified cardiogenic shock, age and heart failure as the only independent predictive variables for early mortality. We conclude that early mortality in the acute myocardial infarction is high and related to severe degrees of pump failure and age.
Martínez Sande
J L
JL
Servicio de Cardiología y de la Unidad Coronaria del Hospital General de Galicia, Santiago de Compostela, España.
Amaro Cendón
A
A
González Juanatey
J R
JR
Pedreira Pérez
M
M
Virgós Lamela
A
A
Jaquet Herter
M
M
Pubul Núñez
V
V
Trillo Nouche
R
R
Casariego Roson
J R
JR
Gil de la Peña
M
M
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004796:Clinical Enzyme Tests; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality*; D011379:Prognosis; D012737:Sex Factors; D012907:Smoking; D013997:Time Factors
Implicaciones clínicas y pronósticas de la edad en el infarto agudo de miocardio.