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Prognosis and outcomes of elderly (75-84 years) patients with acute myocardial infarction 1-2 years after the event - AMI-elderly study of the MONICA/KORA Myocardial Infarction Registry.
Int. J. Cardiol. 149, 205-210 (2011)
BACKGROUND: With increasing life expectancy the management of acute myocardial infarction (AMI) in patients of an older age is of growing importance. However, long-term data are limited regarding 'hard' endpoints and quality of life in unselected elderly patients in 'real world' settings. METHODS AND RESULTS: From March 2005 to March 2006 all 75-84-year old patients consecutively hospitalised due to an incident AMI in a large community teaching hospital were analyzed (N=235). Evidence-based therapy included the treatment with aspirin (93%), clopidogrel (65%), betablockers (93%), angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (84%), and statins (83%). Percutaneous coronary intervention (PCI) was performed in 45.5% and bypass grafting (CABG) in 10.2%. The 28-day-case fatality was 17.4%. Long-term follow-up was obtained in 95.9% of all hospital survivors at a mean of 18.7 ± 6.4 months; during this time 19.9% of patients died. After multivariate analysis the only significantly negative predictor for survival and MACCE was diabetes, and the only significantly positive predictor was revascularisation during hospital stay. Patients with PCI/CABG had lower NYHA class (81% vs. 48%; p<0.04). Patients with PCI also had a higher EQ-5D index score (75 ± 18 vs. 67 ± 17, p<0.04) compared to patients not receiving PCI. CONCLUSION: The positive long-time effect of revascularisation procedures during hospitalisation, not only on 'hard' endpoints but also on functional outcome and quality of life emphasizes that invasive therapies should not be considered less valuable in elderly people and that age alone should not preclude aggressive treatment during AMI.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Myocardial infarction; Elderly; Prognosis; Quality of life
Language
english
Publication Year
2011
HGF-reported in Year
2011
ISSN (print) / ISBN
0167-5273
e-ISSN
1874-1754
Quellenangaben
Volume: 149,
Issue: 2,
Pages: 205-210
Publisher
Elsevier
Reviewing status
Peer reviewed
Institute(s)
Institute of Epidemiology (EPI)
POF-Topic(s)
30202 - Environmental Health
Research field(s)
Genetics and Epidemiology
PSP Element(s)
G-504000-002
G-504090-001
G-504090-001
Scopus ID
79957464980
PubMed ID
20163883
Erfassungsdatum
2011-12-06