Back to Search
Start Over
[Management of myocardial infarction in patients over 75 years of age from 1983 to 1999].
- Source :
-
Archives des maladies du coeur et des vaisseaux [Arch Mal Coeur Vaiss] 2004 Mar; Vol. 97 (3), pp. 201-6. - Publication Year :
- 2004
-
Abstract
- Elderly patients are often excluded from therapeutic methods which have been shown to improve the prognosis of myocardial infarction (MI). The aim of this study was to describe the changes in management of MI in the elderly and to analyse the factors associated with hospital mortality due to MI during this period. All cases of acute MI in patients over 75 years of age from 1983 to 1999 and admitted to the Centre Hospitalier du Val d'Ariège were reviewed. The clinical features, the modalities of initial management and their treatment on discharge were compared by periods: 1983-88, 1989-93 and 1994-99. The changes in hospital mortality and the factors associated with this mortality were studied. Five hundred and forty-four cases of patients with an average age of 81 years were reviewed. The proportion of patients who were treated medically alone decreased over the 3 periods whereas treatment by angioplasty and thrombolysis increased (1.2% in 1983-88 versus 18.2% in 1994-99). Betablockers, ACE inhibitors and aspirin were much more prescribed on discharge from hospital. In parallel, the hospital mortality from MI decreased by half (50.8% in 1983-88 versus 24.9% in 1994-99). The independent factors associated with hospital mortality were age, anterior infarction (OR = 2.08 [1.39-3.13]), revascularisation of the culprit artery by thrombolysis or angioplasty (OR = 0.24 [0.09-0.61]) and the period of hospital stay (OR = 0.22 [0.12-0.38] in 1994-99 compared with 1983-88). The authors' experience reflects an improved prognosis of MI in the elderly partially due to the benefits of treatment by angioplasty and thrombolysis. Improvement of pre-hospital treatment, better diagnostic methods and more aggressive management of the elderly with MI also contribute to these results.
- Subjects :
- Aged
Aged, 80 and over
Angioplasty, Balloon, Coronary statistics & numerical data
Anticoagulants therapeutic use
Cardiovascular Agents therapeutic use
Comorbidity
Drug Therapy, Combination
Female
Fibrinolytic Agents therapeutic use
France epidemiology
Hospital Mortality
Humans
Length of Stay
Male
Myocardial Infarction drug therapy
Myocardial Infarction mortality
Myocardial Infarction surgery
Risk Factors
Thrombolytic Therapy statistics & numerical data
Myocardial Infarction therapy
Subjects
Details
- Language :
- French
- ISSN :
- 0003-9683
- Volume :
- 97
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Archives des maladies du coeur et des vaisseaux
- Publication Type :
- Academic Journal
- Accession number :
- 15106743