[Myocardial infarction in patients over 75 years of age. Hospital characteristics and long-term follow-up].
OBJECTIVE
Analyze management of myocardial infarction in elderly subjects and assess long-term outcome.


METHODS
We studied retrospectively a series of 151 consecutive cases of acute myocardial infarction in patients over 75 years of age and compared then with a group of young subjects under 65 years of age admitted for the same pathology during the same period (1989-1993).


RESULTS
In the elderly population, female sex, past history of angina or infarction, atypical presentation and hemodynamic complications were more frequent in the elderly population (left ventricle failure 44 vs 13%, cardiogenic shock 17.2 vs 0.7% without any difference in localization. Mortality was higher in the elderly group (23.2 vs 2.6%) with 68.6% of the deaths due to primary cardiogenic shock. Beta-blockers were used less frequently in the elderly population (31.8 vs 83.0%) as was thrombolysis (26.5 vs 64.5%); coronography was performed less often (21.8 vs 92.7%) as was percutaneous revascularization (9.9 vs 36.4%) or surgery (1.3 vs 6.6%). Survival at 1, 2 and 5 years was 88, 76 and 57% in the elderly group (Kaplan-Meier plot). A past history of unstable angina and a critical episode of left ventricle failure were factors predicting overmortality.


CONCLUSIONS
Acute myocardial infarction remains a severe condition in patients over 75 years of age with overmortality during hospitalization and poor long-term prognosis. Clinical signs of poor prognosis could help guide selection for more aggressive therapeutic management during the post-infarction period, notably in terms of coronary revascularization.
Jacquemin
L
L
Service de Cardiologie A et B, CHU Brabois, Vandoeuvre-lès-Nancy.
Danchin
N
N
Suty-Selton
C
C
Beurrier
D
D
Grentzinger
A
A
Juillière
Y
Y
Cherrier
F
F
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy; D009204:Myocardial Revascularization; D011379:Prognosis; D012189:Retrospective Studies; D015912:Thrombolytic Therapy
L'infarctus du myocarde chez le sujet âgé de 75 ans ou plus. Charactéristiques hospitalière et suivi à long term.