MYOCARDIAL-INFARCTION IN PATIENTS AGED OV ER 70 - BASED UPON 194 PATIENTS

Among 498 patients hospitalised for myocardial infarction during a thr ee year period, 194 (39%) were aged over 70 (mean age: 78.6+/-6), incl uding 99 women and 95 men. Comparison of this group of patients with t hose aged under 70 showed a significantly higher hospital mortality (1 7.5% v. 6.5%) (p<0.01) and a higher acute complication rate (60.8% v. 23.7% (p<0.01), in particular after the age of 75. Twenty-eight patien ts were treated by thrombolysis (14.4% v. 50.6%) (p<0.05), with a 79.2 % patency rate in follow-up angiography at 48 h, and only one non-fata l hemorrhagic complication. Eighty-six patients were investigated by c oronary arteriography (44.9% v. 87.2% (p<0.05) without any complicatio n. Mean ejection fraction was 57.3 +/- 13.5%. Fifty patients were trea ted by angioplasty (24.6% v. 57%) (p<0.01) including 15 during the acu te phase, with primary success in 40 of them (80%). Ten patients under went coronary bypass following their infarction (5.1% v. 6.25%) (NS) w ith two per- or postoperative deaths (20%). Follow-up study revealed h igh secondary mortality with an overall survival rate at one year of 5 9.6% v. 81% in patients aged under 70 (p<0.01). In total, infarction i n the elderly is characterised by high mortality and morbidity as comp ared with infarctions in patients aged under 70, and requires active m anagement during the acute phase, assessed according to the physiologi cal status and age of the patient.