[ARGEN-IAM-ST Registry: older adults with infarction: Are they all the same?]

Abstract

Introduction: Currently the patient is defined as an older adult (OA) when the age is at least 60 years. Given the long life expectancy, it is interesting to evaluate whether all OAs with acute myocardial infarction (AMI) are equal. The objectives were to know the prevalence of OA in AMI and within them, that of those ≥75 years of age and to analyze characteristics, reperfusion treatments and in-hospital mortality according to whether they are < or ≥ 75 years of age.

Methods: OA patients admitted to the National Registry of Infarction with ST segment elevation (ARGENIAM-ST) were analyzed. They were divided into group 1: 60-74 years old and group 2: ≥ 75 years old and compared with each other.

Results: 3626 AM, 75.9% from Group 1, the rest from Group 2. In group 2 there were more women, hypertensive and with a history of coronary arteries. There was a similar percentage of diabetes and dyslipidemia, but fewer of smokers. In Group 2, less reperfusion treatment was used (although more primary angioplasty), with similar door-to-balloon time. Patients in Group 2 received fewer medications of proven efficacy and in the hospital course, they had more bleeding (although not major), more heart failure and more mortality: 18.3% vs. 9.4%, p<0.001. Age ≥75 years was an independent predictor of mortality.

Conclusions: one in four patients with AMI is over 75 years old; they receive less reperfusion, have more heart failure, bleeding and twice the mortality rate than patients between 60 and 74 years.