title: Long-term trends in short-term outcomes in acute myocardial infarction.
abstract: BACKGROUND
  The objectives of this study were to examine the magnitude of, and 20-year trends in, age differences in short-term outcomes among men and women hospitalized with acute myocardial infarction (AMI) in central Massachusetts.
  
  
  METHODS
  The study population consisted of 5907 male and 4406 female residents of the Worcester, MA, metropolitan area hospitalized at all greater Worcester medical centers with AMI between 1986 and 2005.
  
  
  RESULTS
  Overall, among both men and women, older patients were significantly more likely to have developed atrial fibrillation, heart failure, and to have died during hospitalization and within 30 days after admission compared with patients aged <65 years. Among men, age differences in the risk of developing atrial fibrillation have widened over the past 2 decades, while differences in the risk of developing cardiogenic shock have narrowed for men 75 years and older as compared with those aged <65 years. Among women, age differences in the risk of developing these major complications of AMI have not changed significantly over time. Age differences in short-term mortality have remained relatively unchanged over the past 20 years in both sexes, although individuals of all ages have experienced decreases in short-term death rates over this period.
  
  
  CONCLUSIONS
  Elderly men and women are more likely to experience adverse short-term outcomes after AMI, and age differences in short-term mortality rates have remained relatively unchanged in both sexes over the past 20 years. More targeted treatment approaches during hospitalization for AMI and thereafter are needed for older patients to improve their prognosis.
authors.affiliation: Department of Internal Medicine, Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Hoa L
authors.initials: HL
authors.lastname: Nguyen
authors.forename: Jane S
authors.initials: JS
authors.lastname: Saczynski
authors.forename: Joel M
authors.initials: JM
authors.lastname: Gore
authors.forename: Molly E
authors.initials: ME
authors.lastname: Waring
authors.forename: Darleen
authors.initials: D
authors.lastname: Lessard
authors.forename: Jorge
authors.initials: J
authors.lastname: Yarzebski
authors.forename: George
authors.initials: G
authors.lastname: Reed
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Spencer
authors.forename: Shu-xia
authors.initials: SX
authors.lastname: Li
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Goldberg
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000209:etiology; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000401:mortality*; D012737:Sex Factors; D012770:Shock, Cardiogenic / Q000453:epidemiology* / Q000209:etiology; D013997:Time Factors