OPTIMAL TREATMENT AFTER ACUTE MYOCARDIAL-INFARCTION IN THE ELDERLY

Elderly patients with acute myocardial infarction (AMI) more often hav e a previous history of cardiovascular disease than do younger patient s. Furthermore, they less frequently present with typical symptoms and a typical electrocardiogram pattern. Whereas age is the most importan t predictor for mortality after AMI, the relationship between age and morbidity is more complex. Treatment of elderly patients with AMI is v ery similar to treatment of younger patients. However, the risk of int olerability to various drugs increases with age, and in many instances doses have to be adjusted. In many trials, the number of lives saved with various interventions seem, if anything, to be more numerous amon g the elderly. However, it should be remembered that experience with v arious treatments in the elderly (patients aged > 80 years) is limited . Whether experiences with people aged up to 80 years can be extrapola ted to higher age groups is debatable. With increasing age, there is a n increased frequency of other disabling diseases, as well as generali sed atherosclerosis. It might very well be that even in the elderly it is possible to relieve symptoms and improve morbidity, even though th e effects on the prognosis are likely to be less marked.