Clinical characteristics and outcomes in acute myocardial infarction patients aged ≥65 years in Western Romania

摘要

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.