Infarto agudo al miocardio en pacientes de 80 y más años. Evolución hospitalaria y seguimiento

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 period of five years of follow up, were recorded. Results: Of a total of 1200 patients, 83 (7%) were aged 80 years or older. Among these, 59% were male and 22% were diabetic. The mean lapse between onset of symptoms and admission was 11 hours and 59% were admitted with less than 6 hours of evolution. Sixty three percent had a history of a previous infarction and 24% had a Killip IV classification on admission. Reperfusion therapy was done in 19% and 70% had heart failure during evolution. A coronary angiography was done in 22% and 6% were subjected to revascularization. Mortality was 34%, specially due to cardiogenic shock or ventricular rupture. Of 55 patients discharged from the hospital, 31% died within one year and 64% 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 and long term mortality is high.