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European Heart Journal 1994 15(4):483-488;
Copyright © 1994 by the European Society of Cardiology.
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© 1994 The European Society of Cardiology

Eligibility for reperfusion therapy and outcome in elderly patients with acute myocardial infarction

D. HIMBERT, P. G. STEG, J.-M. JULIARD, F. NEUKIRCH, M.-C. AUMONT and R. GOURGON

From the Service de Cardiologie (Pr R Gourgon), Hôpital Bichat, Paris, France

Received 6 August 1993; revised 2 November 1993; .

Correspondence: Dr Dominique Himbert, Service de Cardiologie, Hôpital Bichat, 46 rue Henri Huchard, 75018 Paris, France

Abstract

Reperfusion therapy by thrombolysis or angioplasty was considered in 260 unselected patients consecutively admitted within 6 h of the onset of Q wave myocardial infarction. Rates of reperfusion and in-hospital mortality were compared in 206 patients <70 years and 54 patients ≥70 years. Early reperfusion was obtained in 864% of the patients under 70 years and in 72·2% of those over 70 (P<0·01). Thrombolysis was more frequently used in the younger group (66·0% vs 31·5%, P<10–5 and primary angioplasty in the older (44·4% vs 29·6%, P<0·05). Overall in-hospital mortality was higher in the older group (22·2% vs 4·4 P<10–5 After successful reperfusion, mortality was 12·8% in the patients over 70 and 3·9% in those under 70. After failed or unproven reperfusion, mortality was 46·7% in the patients over 70 and 7·1% in those under 70. Reperfusion therapy is feasible in the majority of patients over 70 years, but failure to attempt or to achieve reperfusion is associated with a poor outcome. Although not controlled, this study provides an incentive for attempting early reperfusion therapy as often as possible in the elderly with acute myocardial infarction.

Key Words: Elderly • reperfusion • myocardial infarction


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