Prognosis in survivors of acute myocardial infarction occurring at age 70 years or older

Age-Related Differences in Presentation, Treatment and Outcome of Acute Myocardial Infarction

“…The long-term outcome, however, of our patients was mainly deter mined by the functional class at discharge. This is in accordance with data showing that only Killip's class was an independent predic tor of survival in the elderly after surviving the acute episode [2].…”

“…Our findings confirm previous reports on the effect of age on in-hospital mortality [1,2,[5][6][7][8], the proportion of females [ 1,5,7,8] and the prevalence of previous infarction [5] and atypical symptoms on admission [9], Com parison among studies of actual figures, how ever, has to be done with great caution as inclusion and exclusion criteria, and defini tions of the evaluated parameters, may vary from one study to another. Despite these limi tations, all data point to the conclusion that the in-hospital mortality in the elderly is still high and that the 33% mortality in our pa tients >75 years is by no means exceptional.…”

“…As those patients are obviously at risk for rein farction -which may be expected to have a higher than usual fatality rate -they will prob ably contribute to the persisting high mortali ty rate. To strengthen this hypothesis, we like to mention first that in our study the propor tion of patients with previous MI rose sharply to 67% in patients > 75 years, whereas anoth er study between 1973 and 1977 reported a percentage varying from 8 to 31 % without an age-related trend [1], Secondly, our data, like data from other studies, show that, irrespective of age, rein farction bears a worse prognosis than a first MI; we found mortality rates of 12% in pa tients without previous MI and 22% in pa tients with previous MI [2,5], Our second major point of interest was the way the results of clinical trials on MI care were applied in our institution and whether differences among age groups were present or not [6,10,11]. As a rule, data on pharmaco logical treatment do meet standards set by recent trials [12].…”

Acute myocardial infarction in elderly patients: comparative analysis of the predictors of mortality. The elderly versus the young

“…Some authors have reported that acute myocardial infarction in the elderly deserves special consideration be- cause of high in-hospital morbidity and mortality and the pessimistic prognosis during in-hospital stay [11][12][13] . Clinical studies have shown in-hospital mortality ranging from 32% to 60% in this age group, and it could reach 93% to 100% in the presence of cardiogenic shock 14 .…”

Worsening of heart failure during hospital course of an unselected cohort of 2507 patients with myocardial infarction is a factor of poor prognosis: the PRIMA study

“…The prognostic importance of HF has been well established [3,5,13,18,19,25,27–34]. In patients >70 years, Killip class was the only predictor of mortality in multivariate analysis [35]. In‐hospital mortality is 3–10% in Killip class I, 10–30% in class II, approximately 35% in class III, and approximately 60% in class IV [13,14].…”