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Articles

Title: Differences in clinical course of myocardial infarction and long-term prognosis in three age groups of patients

Author:
Marianna Janion
Type:
Original articles
Language:
PL
Journal:
Polish Journal of Cardiology
Year:
1999
Volume:
1
Number:
2
Start page:
121
Final page:
128
ISSN:
1507-5540
Keywords:
myocardial infarction, risk factors, risk stratification, age
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The course of myocardial infarction, hospital mortality and long term prognosis were observed in three groups of patients: group I – 377 patients aged below 60 years; group II – 298 patients aged 60-69 years and group III – 206 patients aged more than 70 years, hospitalised between 1992-1996 due to transmural myocardial infarction. The aim of the present study is to compare the course of myocardial infarction and long term prognosis in three age groups. In patients aged below 70 years the most frequent risk factor was smoking and dyslipidemia, in patients aged more than 70 years – diabetes and arterial hypertension. The anterior localisation of myocardial infarction was observed more frequently in older age groups (35.0% vs. 41.3% vs. 43.2%), the inferior localisation of myocardial infarction in younger age groups (32.4% vs. 30% vs. 26.2%). The clinical course of myocardial infarction was different and the most significant differences were observed between groups I and III. Ventricular arrhythmia was observed more frequently in group I. Supraventricular arrhythmia, intraventricular conduction disorders and heart failure were more frequent in group II and III. Thrombolytic therapy was administered in 31.6% patients in group I, in 20.8% patients in group II and in 6.8% patients in group III. The lowest hospital mortality was observed in group I. It was three times lower than in group II (5% vs. 15.1%) and five times lower than in group III (5% vs. 26.2%). Treatment after hospital discharge was different depending on the age of patients. Aspirin, b-blockers and statins were administered significantly more frequently in group I whereas digitalis and diuretics – significantly less frequently in comparison to older groups. Average 1 – year morbidity in group I was 2.4%, in group II – 4.8% and in group III – 8.1%.