What question did this study set out to answer?

This research aims to compare mortality rates and management of elderly patients with acute myocardial infarction (AMI) over two decades.

January 21, 1997Circulation

Improved Outcome of Elderly Patients (≥75 Years of Age) With Acute Myocardial Infarction From 1981-1983 to 1992-1994 in Israel

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Why the study?

Does management in the reperfusion era (including reperfusion therapies) reduce mortality in elderly patients (≥75 years) with acute myocardial infarction compared to the pre-reperfusion era?

Population

1,155 elderly patients with acute myocardial infarction in coronary care units in Israel.

Comparison

Management in the reperfusion era, including… vs Management before the reperfusion era, without…

Design

Cohort

Follow-up

1 year

Authors

SGShmuel GottliebInterventional Cardiology UGUri GoldbourtGeneral / Preventive / Lipids VBValentina BoykoSheba Medical Center

Discussion

Member takes

Implication

Supports temporal mortality reductions in elderly AMI with reperfusion-era care; leaves open the role of specific interventions.

Key Points

This research aims to compare mortality rates and management of elderly patients with acute myocardial infarction (AMI) over two decades.
Compared in-hospital complications and mortality in two cohorts of elderly AMI patients in Israel from 1981-1983 and 1992-1994.
First cohort included 789 patients from a registry, and the second included 366 patients from nationwide surveys.
Examined the impact of reperfusion therapies introduced in the later cohort.
30-day mortality declined from 38% in 1981-1983 to 27% in 1992-1994 (odds ratio 0.49; 95% CI 0.34 to 0.71).
1-year mortality declined from 52% to 38% (hazard ratio 0.62; 95% CI 0.50 to 0.76).
Marked reduction in 1-year mortality in reperfused patients at 29% (HR 0.45; 95% CI 0.31 to 0.67).

Structured PICO

Does management in the reperfusion era (including reperfusion therapies) reduce mortality in elderly patients (≥75 years) with acute myocardial infarction compared to the pre-reperfusion era?

Population

1,155 elderly patients (≥75 years of age) with acute myocardial infarction in coronary care units in Israel (789 from 1981-1983 and 366 from 1992-1994).

Intervention

Management in the reperfusion era (1992-1994), including reperfusion therapies (thrombolysis, percutaneous transluminal coronary angioplasty, or coronary artery bypass graft surgery).

Comparator

Management before the reperfusion era (1981-1983), without reperfusion therapies.

Outcome

30-day and 1-year mortality rateshard clinical

The introduction of reperfusion therapies and changes in patient management significantly reduced 30-day and 1-year mortality in elderly patients with acute myocardial infarction.

Cite This Study

Gottlieb et al. (1997) studied this question.

synapsesocial.com/papers/6a20d0d3f76165bc1becaf43 https://doi.org/10.1161/01.cir.95.2.342

Topics

Women and heart disease

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Improved Outcome of Elderly Patients (≥75 Years of Age) With Acute Myocardial Infarction From 1981-1983 to 1992-1994 in Israel

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Improved Outcome of Elderly Patients (≥75 Years of Age) With Acute Myocardial Infarction From 1981-1983 to 1992-1994 in Israel

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Topics

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