ACTIVE TREATMENT OF ACUTE MYOCARDIAL-INFARCTION ON MORTALITY AND RECOVERY IN VERY ELDERLY PATIENTS

Aim To assess whether elderly patients derive similar benefit from act ive pharmacological treatment of acute myocardial infarction as the in farct population in general. Methods We compared in-hospital mortality and 2-year survival in two groups of patients aged 80 years or more a nd admitted with acute myocardial infarct to the coronary care unit at Ostra Hospital, Goteborg. in 1984-85, 81 such patients were admitted, none of whom received thrombolytic agents, intravenous nitroglycerin or intravenous beta-blockers. In 1989-90, 137 elderly patients were ad mitted, of whom 20 (15%) received thrombolytic agents, 44 (32%) intrav enous nitroglycerin and 30 (22%) intravenous betablockers. Results In 1984-85, 60 patients (74%) survived to leave the hospital compared to 99 (72%) in 1989-90 (NS). The 2-year survival rate for patients admitt ed in 1984-85 was 36% compared with 39% in 1989-90 (NS). The mean dura tion of hospital stay was 13.6 days for patients discharged alive in 1 984-85 and 10.5 days for those discharged in 1989-90 (P = 0.0043). Con clusions Our findings suggest that while more active pharmacological t reatment of acute myocardial infarction in patients aged 80 years or m ore may have only a limited effect on survival, such treatment may sho rten the hospital stay.