Coronary Artery DiseasesAge-related trends in short- and long-term survival after acute myocardial infarction: a 20-year population-based perspective (1975–1995)☆
Section snippets
Methods
The population under study included residents of the Worcester, Massachusetts, metropolitan area hospitalized with a primary or secondary discharge diagnosis of AMI (International Classification of Disease Code 410) in all acute general hospitals in the Worcester standard metropolitan statistical area during 1975, 1978, 1981, 1984, 1986, 1988, 1990, 1991, 1993, and 1995.1, 2, 3 Sixteen hospitals were included in this study from the mid-1970s through the late 1980s, and fewer hospitals were
Age-related differences in demographic, clinical, and treatment characteristics
Elderly patients were significantly more likely to be women, to have selected comorbid conditions present, and more likely to experience a recurrent, non–Q-wave, anterior AMI, and a smaller infarct as reflected by peak creatine kinase findings (Table I). Elderly patients were significantly more likely to develop congestive heart failure and cardiogenic shock than were younger patients. The elderly were significantly less likely to be treated with each of the pharmacologic agents examined with
Discussion
The results of this multihospital, geographically defined study indicate the following: an adverse impact of increasing age on in-hospital and long-term survival for up to 10 years after AMI; improvements over a 2-decade span in hospital survival in all age groups under study, with the exception of the very elderly, after controlling for potentially confounding prognostic factors; and improvement over the period 1975/78 to 1993/95 in long-term survival rates within the initial 2 years after
Acknowledgements
The investigators are indebted to the cardiology, administration, and medical records departments at participating Worcester metropolitan area hospitals for making this project feasible.
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This study was supported by Grant R01 HL35434 from the National Institutes of Health, Bethesda, Maryland.