Acute myocardial infarction in elderly patients: comparative analysis of the predictors of mortality. The elderly versus the young.
OBJECTIVE
To study the in-hospital evolution of patients aged 65 years and older, with acute myocardial infarction, who were treated by direct coronary angioplasty with no fibrinolytic therapy.


METHODS
We studied 885 patients divided into 2 groups as follows: group I (GI) - 293 (33.4%) patients aged >/= 65 years (72+/-5 years), and group II (GII) - 592 patients aged < 65 years (57+/-9 years). Multivessel disease was more frequent in GI (63.5% x 49.7%; p=0.001). A greater number of GII patients were class I or II of the clinical Killip-Kimball classification (K) (80.2% x 67.2%; p=0.00002), while a significant number of GI patients were KIII and KIV (24.3% x 12.8%; p=0.00003).


RESULTS
Group I had a lower index of success (84.6% x 94%; p=0.0002) and a greater in-hospital mortality (12.2% x 4.7%; p=0.00007). The predictors of mortality in GI were as follows: previous infarction (20.5% x 6.3%; p=0.02), anterior location (13.4% x 6.4%; p=0.03), and male sex (10.4% x 4.4%; p=0.007).


CONCLUSIONS
Elderly patients had more severe acute myocardial infarction and more extensive disease, a lower index of success, and greater in-hospital mortality. Previous infarction, anterior location and male sex were identified as predictors of mortality in the elderly group (GI).
Leal
Marisa F
MF
Centro de Diagnose Cardiovascular, Aliança Saúde, PUCPR, Curitiba, Curitiba, PR, Porto Alegre, RS.
Souza Filho
Newton Fernando Stadler de
NF
Haggi Filho
Hermínio
H
Klosoviski
Estela Regina
ER
Munhoz
Eva Cantalejo
EC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D001938:Brazil / Q000453:epidemiology; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy; D015425:Myocardial Reperfusion / Q000379:methods; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors