title: Myocardial infarction in older than 75 years: An increasing population. CASTUO Study.
abstract: OBJECTIVE
  Elderly patients with acute myocardial infarction constitute a population that is not adequately represented in clinical trials or medical registries. Our objective was to compare the clinical characteristics, treatments administered and mortality among patients younger and older than 75 years.
  
  
  METHODS
  Observational retrospective study of patients hospitalized for acute myocardial infarction in the decade 2000-2009. Multivariate models were constructed to determine hospital and late mortality (median, 4.6 years; IQR 25-75: 2.1-7.3).
  
  
  RESULTS
  We included 2,177 patients (995 men [79%]), with a mean age of 70.8 years (SD, 12.6). A total of 917 (42.0%) of the patients were 75 years of age or older. When compared with the patients younger than 75 years, the older patients had a greater prevalence of diabetes (38.3% vs. 32.5%; P<.002), chronic obstructive pulmonary disease (15.6% vs. 11.2%; P<.002), stroke (14.3% vs. 7.3%; P<.001), chronic renal failure (11.0% vs. 3.9%; P<.001), atrial fibrillation (15.9% vs. 6.9%; P<.001), heart failure (28.0% vs. 23.4%; P<.008). The older patients were treated with fewer beta-blockers (55.9% vs. 71.2%; P<.001), statins (44.3% vs. 62.3%; P<.001), coronary angiographies (17.9% vs. 48.5%; P<.001) and angioplasties (10.8% vs. 29.1%; P<.001). The patients older than 75 years had lower survival (mortality, 44.5% vs. 18.9%; HR 1.89; 95% CI 1.57-2.29). The use of beta-blockers (HR, 0.74; 95% CI 0.62-0.89), statins (HR 0.73; 95% CI 0.58-0.91) and angioplasty (HR, 0.42; 95% CI 0.30-0.57) was inversely correlated with mortality.
  
  
  CONCLUSIONS
  Patients older than 75 years with acute myocardial infarction had lower survival and were treated with fewer beta-blockers, statins and angioplasty, indications that are associated with lower mortality.
authors.affiliation: Sección de Cardiología, Departamento de Medicina Interna, Hospital Don Benito-Villanueva, Don Benito, Badajoz, España; Unidad de Investigación Programa de Investigación en Enfermedades Cardiovasculares PERICLES, Villanueva de la Serena, Badajoz, España. Electronic address: polonibo@gmail.com.
authors.forename: D
authors.initials: D
authors.lastname: Fernández-Bergés
authors.affiliation: Unidad de Investigación Programa de Investigación en Enfermedades Cardiovasculares PERICLES, Villanueva de la Serena, Badajoz, España; Centro de Salud Villanueva de la Serena Norte, Villanueva de la Serena, Badajoz, España.
authors.forename: F J
authors.initials: FJ
authors.lastname: Félix-Redondo
authors.affiliation: Servicio de Cardiología, Hospital Universitario de Santa Lucia, Cartagena, Murcia, España.
authors.forename: L
authors.initials: L
authors.lastname: Consuegra-Sánchez
authors.affiliation: Unidad de Investigación Programa de Investigación en Enfermedades Cardiovasculares PERICLES, Villanueva de la Serena, Badajoz, España; Centro de Salud Mérida Urbano, Mérida, Badajoz, España.
authors.forename: L
authors.initials: L
authors.lastname: Lozano-Mera
authors.affiliation: Unidad de Investigación Programa de Investigación en Enfermedades Cardiovasculares PERICLES, Villanueva de la Serena, Badajoz, España.
authors.forename: I
authors.initials: I
authors.lastname: Miranda Díaz
authors.affiliation: Sección de Cardiología, Departamento de Medicina Interna, Hospital Don Benito-Villanueva, Don Benito, Badajoz, España.
authors.forename: M
authors.initials: M
authors.lastname: Durán Guerrero
authors.affiliation: Sección de Cardiología, Departamento de Medicina Interna, Hospital Don Benito-Villanueva, Don Benito, Badajoz, España.
authors.forename: F
authors.initials: F
authors.lastname: Benítez de Castro
authors.affiliation: Sección de Cardiología, Departamento de Medicina Interna, Hospital Don Benito-Villanueva, Don Benito, Badajoz, España.
authors.forename: J B
authors.initials: JB
authors.lastname: Polanco García
authors.affiliation: Servicio de Hemodinámica, Hospital Universitario Infanta Cristina, Badajoz, España.
authors.forename: J R
authors.initials: JR
authors.lastname: López-Mínguez
keywords: Ancianos; Elderly; Epidemiology; Epidemiología; Infarto de miocardio; Mortalidad; Mortality; Myocardial infarction