title: Prognosis and outcomes of elderly (75-84 years) patients with acute myocardial infarction 1-2 years after the event: AMI-elderly study of the MONICA/KORA Myocardial Infarction Registry.
abstract: BACKGROUND
  With increasing life expectancy the management of acute myocardial infarction (AMI) in patients of an older age is of growing importance. However, long-term data are limited regarding 'hard' endpoints and quality of life in unselected elderly patients in 'real world' settings.
  
  
  RESULTS
  From March 2005 to March 2006 all 75-84-year old patients consecutively hospitalised due to an incident AMI in a large community teaching hospital were analyzed (N=235). Evidence-based therapy included the treatment with aspirin (93%), clopidogrel (65%), betablockers (93%), angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (84%), and statins (83%). Percutaneous coronary intervention (PCI) was performed in 45.5% and bypass grafting (CABG) in 10.2%. The 28-day-case fatality was 17.4%. Long-term follow-up was obtained in 95.9% of all hospital survivors at a mean of 18.7 ± 6.4 months; during this time 19.9% of patients died. After multivariate analysis the only significantly negative predictor for survival and MACCE was diabetes, and the only significantly positive predictor was revascularisation during hospital stay. Patients with PCI/CABG had lower NYHA class (81% vs. 48%; p<0.04). Patients with PCI also had a higher EQ-5D index score (75 ± 18 vs. 67 ± 17, p<0.04) compared to patients not receiving PCI.
  
  
  CONCLUSIONS
  The positive long-time effect of revascularisation procedures during hospitalisation, not only on 'hard' endpoints but also on functional outcome and quality of life emphasizes that invasive therapies should not be considered less valuable in elderly people and that age alone should not preclude aggressive treatment during AMI.
authors.affiliation: I. Medizinische Klinik, Hospital of Augsburg, teaching hospital of the Ludwig Maximilians University München, Augsburg, Germany. Electronic address: bernhard.kuch@klinikum-augsburg.de.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Kuch
authors.affiliation: I. Medizinische Klinik, Hospital of Augsburg, teaching hospital of the Ludwig Maximilians University München, Augsburg, Germany.
authors.forename: Rupert
authors.initials: R
authors.lastname: Wende
authors.affiliation: I. Medizinische Klinik, Hospital of Augsburg, teaching hospital of the Ludwig Maximilians University München, Augsburg, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Barac
authors.affiliation: I. Medizinische Klinik, Hospital of Augsburg, teaching hospital of the Ludwig Maximilians University München, Augsburg, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: von Scheidt
authors.affiliation: I. Medizinische Klinik, Hospital of Augsburg, teaching hospital of the Ludwig Maximilians University München, Augsburg, Germany.
authors.forename: Birgitt
authors.initials: B
authors.lastname: Kling
authors.affiliation: Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany; Hospital of Augsburg, MONICA/KORA Myocardial Infarction Registry, Augsburg, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Greschik
authors.affiliation: Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany; Hospital of Augsburg, MONICA/KORA Myocardial Infarction Registry, Augsburg, Germany.
authors.forename: Christa
authors.initials: C
authors.lastname: Meisinger
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006760:Hospitalization / Q000639:trends; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D011379:Prognosis; D012042:Registries; D016896:Treatment Outcome