2019, Number 1
Reperfusion in acute myocardial infarction in the elderly (clinical characteristics and prognosis). Results of the IMSS Nuevo León Infarction Code Program
Zapata RA, Palacios RJM, De la Cruz OR, Arboine AL, Sierra FÁ, Muñoz CC
Language: English
References: 10
Page: 28-33
PDF size: 229.21 Kb.
ABSTRACT
Introduction: The age is an important prognostic factor in patients with acute myocardial infarction. As there are no data in the Mexican population, it is important to establish the characteristics and prognosis of older adults in whom mechanical reperfusion treatment is carried out. Methods and results: We carried out a retrospective analysis from January 1, 2016 to December 31, 2017 in which a total of 1,025 patients were included in the Infarction Code Program and received a myocardial reperfusion treatment, being the 15.3% over the age of 75 years of our patients. The age range was 33 to 92 years. The mortality rate increased exponentially with age (3.4% for patients ≤ 54 years, 6.1% for 55 to 64 years, 9.2% for 65 to 75 years and 15.9% for ≥ 75 years, p ‹ 0.001). In patients older than 75 years-old, primary angioplasty is the preferred method of reperfusion (77.7%), without an increase in cerebrovascular events. Over the age of 75 years-old, patients who develop cardiogenic shock have a higher mortality compared with younger ones (17.6, 28, 33 vs 56%, p ‹ 0.001). Conclusions: Despite the different treatments of reperfusion, mortality remains higher in older adults, mainly due to multiple comorbidities and a higher rate of ventricular dysfunction.REFERENCES
Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018; 39 (2): 119-177.