Introduction and aim: New therapies have been added that improve prognosis of patients with myocardial infarction. Our purpose was to know if elderly patients reach benefit from these therapeutic changes.
Methods: We have analyzed the clinical data of 227 patients older than 70 who were admitted in our coronary care unit: 78 admitted in 1980-81 and 14 admitted in 1990-91.
Results: Although differences were not significant, in 1990-91 there were more women (36% versus 28%), less smoking (24% versus 33%), more patients with previous infarction (19% versus 12%), more hypertension (53% versus 43%), less anterior infarcts (38% versus 45%) more non Q infarcts (11% versus 1%), and less bundle branch block (21% versus 31%). In 1990-91, pacemakers were used less often (13% versus 27%, p = 0.03), thrombolytic therapy was given to 16 patients (10.7%), and the mortality rate was a little inferior (22% versus 30%, not significant). Female sex, not being a smoker, Killip class and bundle branch block were significantly related to mortality. After a multivariate analysis in which these factors we included, the date of admission resulted an independent predictor of mortality, with an odds ratio of 1990-91 to 1980-81 of 0.43 (p = 0.039).
Conclusions: The management of patients older than 70 with myocardial infarction has improved, with a significantly lesser risk of dead after multivariate analysis, despite that thrombolysis has been scarcely applied.