Open AccessClinical characteristics and outcomes in acute myocardial infarction patients aged ≥65 years in Western Romania
Author(s) -
Florina Căruntu,
Diana Aurora Bordejevic,
M Tomescu,
Ioana Mihaela Citu
Publication year - 2021
Publication title -
reviews in cardiovascular medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.555
H-Index - 39
eISSN - 2153-8174
pISSN - 1530-6550
DOI - 10.31083/j.rcm2203098
Subject(s) - medicine , myocardial infarction , killip class , conventional pci , percutaneous coronary intervention , mortality rate , logistic regression , retrospective cohort study , clinical endpoint , population , observational study , cardiology , clinical trial , environmental health
Older age is known as a negative prognostic parameter in patients with acute myocardial infarction (AMI). In this study, we aimed to investigate age-related differences in treatment protocols, in-hospital and 1-year mortality. This retrospective observational single-center study enrolled consecutive AMI patients with an urgent percutaneous coronary intervention (PCI) as the main method of myocardial revascularization. The patients divided were divided by age into group I (≥65 years) and group II (<65 years). The primary endpoint was in-hospital mortality, the secondary endpoints were 1-year mortality and rehospitalization rates. Of the 522 admitted with AMI, 476 were enrolled in the study. The mean age was 67 ± 13 years; 62% were men. Group I patients had a significantly lower rate of performed PCI (65% vs. 79%, P < 0.001). 53 patients (12.3%) died during hospitalization, and this proportion was notably higher in the older population (20% vs. 6%, P < 0.0001). The cardiac causes of death were more frequent in group I patients (12% vs. 5.6%, P = 0.016). The multivariate logistic regression selected two variables as independent predictors for the risk of in-hospital death: age ≥65 years ( P = 0.0170), and Killip class at admission ( P < 0.0001). The 1-year mortality was 3.3%, slightly higher in group I patients (4.8% vs. 1.5%, P = 0.05). In conclusion, patients aged ≥65 years have three times higher in-hospital mortality, but similar 1-year mortality and readmission rates when compared with the younger patients. It is obvious that there is a large potential for improvement of the AMI care in this age group of patients.