title: [Type of treatment and short-term outcome in elderly patients with acute myocardial infarction admitted to hospitals with a primary coronary angioplasty facility. The TRIANA (TRatamiento del Infarto Agudo de miocardio eN Ancianos) Registry].
abstract: OBJECTIVE
  The nature and outcome of treatment for acute myocardial infarction in elderly patients admitted to Spanish hospitals with primary angioplasty facilities are not well documented.
  
  
  METHODS
  Prospective analysis of registry data on patients > or =75 years old with ST-segment-elevation acute myocardial infarction admitted between April and July 2002 to Spanish hospitals with an active primary angioplasty program.
  
  
  RESULTS
  We followed up 410 consecutive patients for 1 month. Their mean age was 80 (4.3) years and 46% were female. The median delay between symptom onset and arrival at hospital was 190 minutes. Around 42% of patients received no reperfusion therapy, 35% were treated by thrombolysis, and 22% by primary angioplasty. Patients who underwent reperfusion therapy were younger, were more frequently male, had a shorter delay from symptom onset to hospital arrival, and had a better initial hemodynamic status (Killip Class). However, they were more likely to have extensive anterior infarctions. Overall, 30-day mortality was 24.9%. Independent predictors of death were age, systolic blood pressure, and Killip class >1, but not use of thrombolysis or primary angioplasty.
  
  
  CONCLUSIONS
  Over 42% of elderly patients with myocardial infarction admitted to Spanish hospitals with angioplasty facilities did not receive reperfusion therapy. Thrombolysis was the most frequently used reperfusion therapy. However, neither thrombolysis nor primary angioplasty improved 30-day mortality.
authors.affiliation: Servicio de Cardiología, Hospital Universitario Joan XXIII, Tarragona, España. abardaji@comt.es
authors.forename: Alfredo
authors.initials: A
authors.lastname: Bardají
authors.forename: Héctor
authors.initials: H
authors.lastname: Bueno
authors.forename: Antonio
authors.initials: A
authors.lastname: Fernández-Ortiz
authors.forename: Angel
authors.initials: A
authors.lastname: Cequier
authors.forename: Josep M
authors.initials: JM
authors.lastname: Augé
authors.forename: Magda
authors.initials: M
authors.lastname: Heras
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D002986:Clinical Trials as Topic; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D013030:Spain; D013997:Time Factors; D016896:Treatment Outcome