Article
Guideline based treatment of 5079 patients (<=/>75years) with acute myocardial infarction of the Berlin Myocardial Infarction Registry
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Published: | September 8, 2005 |
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Outline
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Background
Incidence and mortality of acute myocardial infarction (AMI) increases with age. In Berlin 26% of patients with acute myocardial infarction are older than 75 years but 53% of those who die are over 75years. How does therapy differ between younger and old patients and may thereby influence prognosis? [Ref. 1], [Ref. 2]
Methods
Between 1999 and 2003 data of 5079 patients with acute myocardial infarction were prospectively collected from 25 hospitals in Berlin. 1319 pts were older than 75 years. We present clinical, treatment and outcome data of these two populations.
Results
The overall infarct mortality rate is 11.6%. In the patients > 75years mortality rate is 23.7%, in the younger ones 7.3%. Some differences in their treatment are shown in Tab 1. [Tab. 1]
In a multivariate analysis the following independent predictors of hospital mortality for patients > 75years were calculated: age in years (OR=1.06), pre-existing heart failure (OR=2.38), pre-hospital cardiopulmonary resuscitation (OR=10.6), and cardiogenic shock (OR=2.73) on admission, admission to a hospital with > 600 beds (OR=0.64) and time between onset of symptoms and hospital arrival >12h (OR=1.68), ST elevation in initial ECG (OR=2.09), reperfusion therapy (OR=0.64), as well as beta-blocker (OR=0.47) and ACE inhibitor treatment (OR=0.49) within 48h after hospitalization.
Discussion
References
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