Coronary artery diseaseAngiographic and clinical characteristics associated with increased in-hospital mortality in elderly patients with acute myocardial infarction undergoing percutaneous intervention (a pooled analysis of the primary angioplasty in myocardial infarction trials)
Section snippets
Methods
The information was obtained from review of the databases from 3 primary angioplasty trials (PAMI-2,18 Stent PAMI,19 and PAMI No Surgery On Site20) maintained at the PAMI Coordinating Center at William Beaumont Hospital, Royal Oak, Michigan. These trials involved 1,100 patients (recruited between June 1990 and April 1992), 1,458 patients (recruited between September 1993 and January 1995), and 474 patients (recruited between August 1996 and June 1998) for a total of 3,032 patients. All trials
Results
There were 2,580 patients (85%) aged <75 years and 452 (15%) aged ≥75 years. Older patients were smaller and more likely to be women and had a higher Killip class at presentation (Table I). Cardiac risk factors and comorbidities more prevalent among older patients included hypertension, diabetes mellitus, history of congestive heart failure, prior AMI, history of peripheral vascular disease, and history of a cerebral vascular accident. Those more common in younger patients included
Discussion
As life expectancy continues to increase, cardiologists can expect to encounter a significant increase in the number of patients with AMI who are ≥75 years old. In the era before reperfusion, elderly patients had 1-month and 1-year mortality rates of 30% and 75%, respectively.21, 22 Our study attempts to use information obtained at acute cardiac catheterization to identify the mechanism(s) of this increased risk and to define predictors that may help the clinician identify a high-risk subset of
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2017, Toxicology and Applied PharmacologyCitation Excerpt :However, young mice (2–3 months) typically recover from MI induced by LAD coronary occlusion, surviving for months without showing significant signs of heart failure (Michael et al., 1999; Gould et al., 2002). Older mice, e.g. 14-months old, develop heart failure after MI (Gould et al., 2002), making the model relevant to humans, since the occurrence of MI is of a particular concern to the elderly, who is at the risk of developing heart failure and has a higher mortality rate (St John Sutton et al., 1997; DeGeare et al., 2000; Haase et al., 2000). Economically, because of the expenses of keeping experimental animals to old age, a new model that can develop heart failure within a short period of time following MI is useful for studying the pathophysiology and for drug development against heart failure.