Key result
Elderly patients aged ≥75 years presenting with acute myocardial infarction had a 4-fold higher adjusted risk of 1-year mortality compared to younger patients (HR 4.0).
Why the study?
The study was conducted to provide insight into the real-life clinical presentation and outcomes of elderly patients presenting with acute myocardial infarction.
Observational (n=1,930)
Yes
Effect estimate: HR 4.0 (95% CI 2.9-5.6)
Absolute Event Rate: 22.7% vs 5.8%
p-value: p=<0.001
Elderly patients (≥75 years) presenting with acute myocardial infarction face prolonged ischemic times, receive less intensive therapies, and have a significantly higher 1-year mortality risk compared to younger patients.
Supports heightened vigilance for elderly AMI patients; leaves open whether closing treatment gaps improves survival.
BACKGROUND: The aim of this study was to provide insight into the real-life clinical presentation and outcomes of the elderly presenting with acute myocardial infarction from the Turkish Myocardial Infarction registry database. METHODS: TURKMI was a nationwide, multicenter, observational, 15-day snapshot registry conducted to address the management of acute myocardial infarction patients admitted to percutaneous intervention-capable hospitals. The present analysis included the comparison of consecutively enrolled acute myocardial infarction patients aged ≥75 and <75 years. RESULTS: Of the overall 1930 patients, 362 patients were aged ≥75 years. Elderly patients were more likely to have hypertension and renal failure and less likely to have hypercholesterolemia. Elderly patients were admitted to hospitals almost 1 hour later mainly due to a late call to emergency medical service. At discharge, medical therapies were significantly less prescribed to the elderly. The proportion of patients undergoing coronary angiography was significantly lower in elderly (81.8% vs. 96.4%, P < .001). Both in-hospital and 1-year mortality were significantly higher in elderly patients (9.1% vs. 2.7% and 22.7% vs. 5.8%, P < .001 respectively). The adjusted risk of 1-year mortality was 4-fold in elderly (hazard ratio and 95% CI 4.0 [2.9-5.6], P < .001). In multivariate analysis, every 5-beat/min increase in heart rate increased mortality by 7%. Higher heart rate and use of antiplatelet agents on admission were predictors of mortality in elderly. CONCLUSION: In real-life settings, elderly patients presenting with acute myocardial infarction are prone to prolonged total ischemic time and are subjected to less-intensive medical treatment and interventional approaches. Besides age, the increased heart rate could be the major determinant of mortality.
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Özdoğan et al. (2022) conducted an observational in Acute Myocardial Infarction (n=1,930). Age ≥75 years vs. Age <75 years was evaluated on 1-year mortality (HR 4.0, 95% CI 2.9-5.6, p=<0.001). Elderly patients aged ≥75 years presenting with acute myocardial infarction had a 4-fold higher adjusted risk of 1-year mortality compared to younger patients (HR 4.0).
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