Eligibility for reperfusion therapy and outcome in elderly patients with acute myocardial infarction |
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Authors: | HIMBERT, D. STEG, P. G. JULIARD, J.-M. NEUKIRCH, F. AUMONT, M.-C. GOURGON, R. |
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Affiliation: | From the Service de Cardiologie (Pr R Gourgon), Hôpital Bichat, Paris, France |
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Abstract: | Reperfusion therapy by thrombolysis or angioplasty was consideredin 260 unselected patients consecutively admitted within 6 hof the onset of Q wave myocardial infarction. Rates of reperfusionand in-hospital mortality were compared in 206 patients <70years and 54 patients 70 years. Early reperfusion was obtainedin 864% of the patients under 70 years and in 72·2% ofthose over 70 (P<0·01). Thrombolysis was more frequentlyused in the younger group (66·0% vs 31·5%, P<105and primary angioplasty in the older (44·4% vs 29·6%,P<0·05). Overall in-hospital mortality was higherin the older group (22·2% vs 4·4 P<105After successful reperfusion, mortality was 12·8% inthe patients over 70 and 3·9% in those under 70. Afterfailed or unproven reperfusion, mortality was 46·7% inthe patients over 70 and 7·1% in those under 70. Reperfusiontherapy is feasible in the majority of patients over 70 years,but failure to attempt or to achieve reperfusion is associatedwith a poor outcome. Although not controlled, this study providesan incentive for attempting early reperfusion therapy as oftenas possible in the elderly with acute myocardial infarction. |
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Keywords: | Elderly reperfusion myocardial infarction |
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