title: Acute myocardial infarction population incidence and in-hospital management factors associated to 28-day case-fatality in the 65 year and older.
abstract: OBJECTIVE
  The myocardial infarction (MI) incidence rate, prognosis and hospitalisation rate in the population 65 and over are rarely studied. We sought to determine MI hospitalisation and incidence rates, and 28-day case-fatality, in the 65 year and older population, and to analyse whether their management and prognosis differed from that of younger patients.
  
  
  METHODS
  All residents in Gerona (Spain) older than 24 years with suspected fatal or non-fatal MI were investigated and included in a population registry.
  
  
  RESULTS
  MI mortality, incidence, and case-fatality dramatically increased with age after 64. Smoking, thrombolysis, antiplatelet and betablocker drug use, coronary angiograms, and coronary revascularisation decreased with age. The risk of death of patients between 75 and 84 years (OR: 4.15, 95% confidence interval, CI: 1.70-10.15) and between 85 and 94 years (OR: 4.68, 95% CI: 1.62-13.52) was higher than in the 34-64 years age group, independently of any patient characteristic.
  
  
  CONCLUSIONS
  The magnitude of the impact of MI in the elderly at population and hospital levels is substantially higher than in those younger than 65 years of age. After this age patients receive less treatments and procedures than their younger counterparts.
authors.affiliation: Lipids and Cardiovascular Epidemiology Unit, Institut Municipal d'Investigació Mèdica, Barcelona, Spain. jmarrugat@imim.es
authors.forename: Jaume
authors.initials: J
authors.lastname: Marrugat
authors.forename: Joan
authors.initials: J
authors.lastname: Sala
authors.forename: Josep Masia
authors.initials: JM
authors.lastname: Manresa
authors.forename: Miguel
authors.initials: M
authors.lastname: Gil
authors.forename: Roberto
authors.initials: R
authors.lastname: Elosua
authors.forename: Gloria
authors.initials: G
authors.lastname: Pérez
authors.forename: Xavier
authors.initials: X
authors.lastname: Albert
authors.forename: Araceli
authors.initials: A
authors.lastname: Pena
authors.forename: Rafael
authors.initials: R
authors.lastname: Masiá
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006302:Health Services Research; D006801:Humans; D015994:Incidence; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000401:mortality; D012042:Registries; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology