REVIEW – January 2005

Impact of age on management and outcome in patients with acute myocardial infarction


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The number of elderly patients with acute myocardial infarction (AMI) is growing rapidly. Their mortality has remained high, although mortality after AMI declined during the past three decades. One reason might be that older age reduces the likelihood that a patient will receive recommended therapies. The objective of this study was to assess age-related differences in the risk factors, management and mortality of patients with AMI. The study included data of consecutive unselected patients from the Myocardial Infarction Registry, who were admitted to Tartu University Clinics within a period of three years. The patients were stratified into five age groups: <55 years, 55–64 years, 65–74 years, 75–84 years, ≥85 years. Our data demonstrate that age influences occurrence of the risk factors and comorbidities, as well as the management and in-hospital mortality of AMI patients. Elderly patients are less likely to receive guideline-indicated therapies when hospitalised with MI, but this varies among medications. The oldest patients (≥85 years) receive the least of these therapies and have drastically high in-hospital mortality. Further studies are warranted to determine the efficacy of medications and management strategies in outcome in elderly patients with AMI.