[Acute reperfusion therapy in elderly women with acute myocardial infarction with ST-segment elevation: efficacy in the reduction of their mortality].
OBJECTIVE
Elderly patients with acute coronary syndromes, particularly elderly women, suffer higher mortality and more morbidity than their younger counterparts. We try to document the outcome, treatment received and prognostic factors in this group.


METHODS
All data for ST-segment elevation myocardial infarction in women aged >/= 75 admitted to our hospital from 2002 to 2007 were retrospectively collected, including epidemiological and clinical variables, vascular complications, in-hospital outcome and middle-term follow-up. These data were analysed and compared depending on reperfusion therapy or not on admission. We determined the causes of not receiving this therapy and the causes of mortality.


RESULTS
A total of 195 females were identified. Mean age was 82.7, diabetics 33% and 41% had anterior wall myocardial infarction. Killip III-IV was found in 26.2%. 25.6% of patients underwent reperfusion therapy. In-hospital mortality was 28.7% and 6-months mortality was 39.8%. During one-year follow-up, the major cardiac events rate in these patients was 45.7%. Age, left bundle-branch block o pacemaker rhythm in the electrocardiogram, delayed admission and medical decision were associated with lower reperfusion therapy rates. Death rate was clearly lower (2.7 times) in treated patients although relative risk of bleeding complications was higher. The absence of reperfusion therapy, high Killip on admission and low left ventricular ejection fraction were independently associated with higher mortality.


CONCLUSIONS
Acute myocardial infarction in elderly women remains a high morbidity and mortality pathology. This group is less likely to receive acute reperfusion therapies, which have apparently been proven to improve outcome and decrease the mortality rate.
Moreno Ambroj
Cristina
C
Unidad de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario Miguel Servet, Zaragoza, España. crystynama@hotmail.com
Galache Osuna
José Gabriel
JG
Sánchez-Rubio Lezcano
Juan
J
Calvo Cebollero
Isabel
I
Ferrer Gracia
María Cruz
MC
Placer Peralta
Luis Javier
LJ
D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D004562:Electrocardiography; D005260:Female; D006801:Humans; D009203:Myocardial Infarction / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy*; D015425:Myocardial Reperfusion; D012189:Retrospective Studies; D015912:Thrombolytic Therapy