Infarto agudo al miocardio en pacientes de 80 y más años. Evolución hospitalaria y seguimiento / Clinical features and prognosis of acule myocardial infarction among patients aged 80 years or older

ABSTRACT

Background: Subjects older than 80 years have more complicated acute myocardial infarctions and are subjected to less reperfusion procedures. Aim: To describe the hospital evolution and follow up of patients older than 80 years, suffering an acute myocardial infarction. Material and methods: Patients older than 80 years, were selected from a prospective registry of acute myocardial infarction. Among these, the hospital evolution, mortality and events during a períod ofñve years of follow up, were recorded. Results: Of a total of 1200 patients, 83 (7 percent) were aged 80 years or older. Among these, 59 percent were male and 22 percent were diabetic. The mean lapse between onset of symptoms and admission was 11 hours and 59 percent were admitted with less than 6 hours of evolution. Sixty three percent had a history of a previous infarction and 24 percent had a Killip IV classification on admission. Reperfusion therapy was done in 19 percent and 70 percent had heart failure during evolution. A coronary angiography was done in 22 percent and 6 percent were subjected to revascularization. Mortality was 34 percent, specially due to cardiogenic shock or ventricular rupture. Of 55 patients discharged from the hospital, 31 percent died within one year and 64 percent within five years, mainly due to cardiac causes. Conclusions: Patients aged 80 years or older have more complicated myocardial infarctions, most of them are managed conservatively andlong term mortality is high.