Impact of Combination Evidence-Based Medical Therapy on Mortality Following Myocardial Infarction in Elderly Patients

Edgar Lik-Wui Tay MBBS, Mark Chan MBBS, Virlynn Tan MSc, Ling Ling Sim MSc, Huay-Cheem Tan MBBS, Yeo Tiong Cheng MBBS
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引用次数: 10

Abstract

Antiplatelet drugs, β-blockers, statins, and angiotensinogen-converting enzyme inhibitors reduce mortality following myocardial infarction (MI). The data on the impact of combination evidence-based medications on mortality following acute MI in elderly patients are limited. In this study, 5529 patients with MI admitted between January 2000 and December 2003 were assessed. Based on discharge use of evidence-based medications, the patients were divided into those using 0, 1, 2, 3, or 4 medications. The impact of medications on 1-year mortality was assessed for patients younger than 75 years and 75 years and older. Mean age of the patients was 63±13 years (71% male). The unadjusted 1-year mortality post-MI was 18.3% and 52.7% for young and elderly patients, respectively. Compared with patients with 0 medications, the adjusted odds ratio for 1-year mortality was lower in patients with 1, 2, 3, and 4 medications in both groups. Use of combination evidence-based medications was independently associated with lower 1-year post-MI mortality irrespective of age.

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循证药物联合治疗对老年患者心肌梗死后死亡率的影响
抗血小板药物、β受体阻滞剂、他汀类药物和血管紧张素转换酶抑制剂可降低心肌梗死(MI)后的死亡率。关于联合循证药物治疗对老年急性心肌梗死患者死亡率影响的数据有限。本研究对2000年1月至2003年12月间收治的5529例心肌梗死患者进行了评估。根据出院时使用循证药物的情况,将患者分为使用0、1、2、3、4种药物的组。药物对75岁以下和75岁及以上患者1年死亡率的影响进行了评估。患者平均年龄63±13岁,男性占71%。年轻和老年患者mi后1年未调整死亡率分别为18.3%和52.7%。与不使用任何药物的患者相比,两组使用1、2、3和4种药物的患者1年死亡率的校正优势比均较低。联合循证药物的使用与心肌梗死后1年死亡率的降低独立相关,与年龄无关。
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