[Infarction in patients aged over 70. Apropos of 194 patients].
Among 498 patients hospitalised for myocardial infarction during a three year period, 194 (39%) were aged over 70 (mean age: 78.6 +/- 6), including 99 women and 95 men. Comparison of this group of patients with those aged under 70 showed a significantly higher hospital mortality (17.5% v. 6.5%) (p < 0.01) and a higher acute complication rate (60.8% v. 23.7% (p < 0.01), in particular after the age of 75. Twenty-eight patients were treated by thrombolysis (14.4% v. 50.6%) (p < 0.05), with a 79.2% patency rate in follow-up angiography at 48 h, and only one non-fatal hemorrhagic complication. Eighty-six patients were investigated by coronary arteriography (44.9% v. 87.2% (p < 0.05) without any complication. Mean ejection fraction was 57.3 +/- 13.5%. Fifty patients were treated by angioplasty (24.6% v. 57%) (p < 0.01) including 15 during the acute phase, with primary success in 40 of them (80%). Ten patients underwent coronary bypass following their infarction (5.1% v. 6.25%) (NS) with two per- or postoperative deaths (20%). Follow-up study revealed high secondary mortality with an overall survival rate at one year of 59.6% v. 81% in patients aged under 70 (p < 0.01). In total, infarction in the elderly is characterised by high mortality and morbidity as compared with infarctions in patients aged under 70, and requires active management during the acute phase, assessed according to the physiological status and age of the patient.
Beard
T
T
Service de Cardiologie, Hôpital Purpan, Toulouse.
Carrié
D
D
Boudjemaa
B
B
Ferrières
J
J
Delay
M
M
Bernadet
P
P
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D017130:Angioplasty; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D012307:Risk Factors; D011795:Surveys and Questionnaires; D015912:Thrombolytic Therapy; D016896:Treatment Outcome
Infarctus du sujet de plus de 70 ans. A propos de 194 patients.