Pharmacological therapy for myocardial infarction in the elderly: An 8-year analysis.
OBJECTIVE
To assess the changes in the medicamentous treatment of elderly patients hospitalized with acute myocardial infarction occurring over an 8-year period.


METHODS
We retrospectively analyzed 379 patients above the age of 65 years with acute myocardial infarction who were admitted to the coronary unit of a university-affiliated hospital from 1990 to 1997. The patients were divided into 2 groups, according to the period of time of hospital admission as follows: group 1 - from 1990 to 1993; and group 2 - from 1994 to 1997.


RESULTS
The use of beta-blockers (40.8% X 75.2%, p<0.0001) and angiotensin-converting enzyme inhibitors (42% X 59.5%, p=0.001) was significantly greater in group 2, while the use of calcium antagonists (42% X 18.5%, p<0.0001) and general antiarrhythmic drugs (19.1% X 10.8%, p=0.03) was significantly lower. No significant difference was observed in regard to the use of acetylsalicylic acid, thrombolytic agents, nitrate, and digitalis in the period studied. The length of hospitalization was shorter in group 2 (13.4+/-8.9 days X 10.5+/-7.5 days, p<0.001). The in-hospital mortality was 35.7% in group 1 and 26.6% in group 2 (p=0.07).


CONCLUSIONS
Significant changes were observed in the treatment of elderly patients with acute myocardial infarction, with a greater use of beta-blockers and angiotensin-converting enzyme inhibitors and a lower use of calcium antagonists and antiarrhythmic drugs in group 2. The length of hospitalization and the mortality rate were also lower in group 2, even though the reduction in mortality was not statistically significant.
Makdisse
Márcia Regina Pinho
MR
Escola Paulista de Medicina, Universidade Federal de São Paulo, Brasil. marciamakdisse@yahoo.com
Matsushita
Andrea de M
Ade M
Goncalves
Iran
I
Miranda
Odete
O
Gomes
Ana Cristina
AC
Cartocci
Monica M
MM
Covre
Silvia
S
Carvalho
Antonio Carlos de Camargo
AC
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001938:Brazil / Q000453:epidemiology; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality; D012189:Retrospective Studies
D000889:Anti-Arrhythmia Agents; D002121:Calcium Channel Blockers