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首页> 外文期刊>International Journal of Cardiology >Prognosis and outcomes of elderly (75-84 years) patients with acute myocardial infarction 1-2 years after the event - AMI-elderly study of the MONICA/KORA Myocardial Infarction Registry.
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Prognosis and outcomes of elderly (75-84 years) patients with acute myocardial infarction 1-2 years after the event - AMI-elderly study of the MONICA/KORA Myocardial Infarction Registry.

机译：事件发生后1-2年的老年（75-84岁）急性心肌梗死患者的预后和结果-MONICA / KORA心肌梗死注册资料库的AMI老年人研究。

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BACKGROUND: With increasing life expectancy the management of acute myocardial infarction (AMI) in patients of an older age is of growing importance. However, long-term data are limited regarding 'hard' endpoints and quality of life in unselected elderly patients in 'real world' settings. METHODS AND RESULTS: From March 2005 to March 2006 all 75-84-year old patients consecutively hospitalised due to an incident AMI in a large community teaching hospital were analyzed (N=235). Evidence-based therapy included the treatment with aspirin (93%), clopidogrel (65%), betablockers (93%), angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (84%), and statins (83%). Percutaneous coronary intervention (PCI) was performed in 45.5% and bypass grafting (CABG) in 10.2%. The 28-day-case fatality was 17.4%. Long-term follow-up was obtained in 95.9% of all hospital survivors at a mean of 18.7 +/- 6.4 months; during this time 19.9% of patients died. After multivariate analysis the only significantly negative predictor for survival and MACCE was diabetes, and the only significantly positive predictor was revascularisation during hospital stay. Patients with PCI/CABG had lower NYHA class (81% vs. 48%; p<0.04). Patients with PCI also had a higher EQ-5D index score (75 +/- 18 vs. 67 +/- 17, p<0.04) compared to patients not receiving PCI. CONCLUSION: The positive long-time effect of revascularisation procedures during hospitalisation, not only on 'hard' endpoints but also on functional outcome and quality of life emphasizes that invasive therapies should not be considered less valuable in elderly people and that age alone should not preclude aggressive treatment during AMI.
机译：背景：随着预期寿命的增加，老年患者急性心肌梗死（AMI）的管理变得越来越重要。但是，关于“现实世界”环境中未选定的老年患者的“硬性”终点和生活质量的长期数据有限。方法与结果：从2005年3月至2006年3月，对在一家大型社区教学医院因AMI事件而连续住院的所有75-84岁患者进行了分析（N = 235）。循证治疗包括使用阿司匹林（93％），氯吡格雷（65％），β受体阻滞剂（93％），血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂（84％）和他汀类药物（83％）的治疗。经皮冠状动脉介入治疗（PCI）占45.5％，旁路移植术（CABG）占10.2％。 28天病死率为17.4％。 95.9％的医院幸存者获得了长期随访，平均随访时间为18.7 +/- 6.4个月;在此期间，有19.9％的患者死亡。经过多变量分析，存活率和MACCE的唯一显着阴性指标是糖尿病，而住院期间的血运重建是唯一显着阳性指标。 PCI / CABG患者的NYHA等级较低（81％比48％; p <0.04）。与未接受PCI的患者相比，患有PCI的患者的EQ-5D指数得分也更高（75 +/- 18对67 +/- 17，p <0.04）。结论：住院期间血运重建程序的长期长期积极影响，不仅对“硬性”终点，而且对功能结局和生活质量的影响都强调，侵入性疗法不应被认为对老年人的价值较低，并且不应排除年龄的限制AMI期间积极治疗。

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