[Thrombolysis in acute myocardial infarction in the aged. A greater risk of cardiac rupture?].
OBJECTIVE
To evaluate age group and i.v. thrombolytic therapy (TT) influences on cardiac rupture complicating acute myocardial infarction (AMI). CONCEPTION: Retrospective analysis of patients (pts) admitted during 1988-89 to an Intensive Care Unit of a Terciary Hospital (UCIM) with AMI.


METHODS
430 pts were admitted with AMI. During this period 89 pts were submitted to TT (25% age greater than or equal to 65 years). Eighty four pts died during hospital stay and 42 had autopsy study (50%). Only 7 of nonautopsied pts died of undetermined cause. Dead pts had age m +/- SD 72 +/- 11 years old (yo) (37% female, 63% male and 74% age greater than or equal to 65 yo).


RESULTS
Nineteen pts died of cardiac rupture (CR) (23%). CR prevalence was 1.4% (3/218) in pts less than 65 yo and 7.5% (16/212) in pts greater than or equal to 65 yo (p less than 0.01). CR prevalence in pts submitted to TT (4.5%) 4/89, was similar to pts not submitted to TT (4.4%) 15/341 (n.s.). Pts less than 65 yo had nonsignificant differences in CR wether submitted or not to TT (0% vs 2%). Elderly pts (greater than or equal to 65 yo) CR prevalence was 18% (4/22) in those submitted to TT vs 6% (12/190) in those not submitted to TT (p less than 0.05).


CONCLUSIONS
Thrombolytic therapy may carry an additional risk for cardiac rupture in elderly patients (greater than or equal to 65 yo).
Pedro
P G
PG
Interno da Especialidade de Cardiologia do Hospital de Santa Maria.
Pereirinha
A
A
Fiúza
M
M
Correia
L C
LC
Dias
E
E
Pinto
F
F
Carvalho
M
M
Vega
J
J
Silva
Z
Z
Lacerda
A
A
D000367:Age Factors; D000368:Aged; D005260:Female; D006342:Heart Rupture, Post-Infarction / Q000139:chemically induced* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D015912:Thrombolytic Therapy / Q000009:adverse effects*
Trombólise no enfarte agudo do miocárdio no idoso. Um risco acrescido de ruptura cardíaca?