Acute myocardial infarction in the elderly people. Influence of comorbidity

pp. 160-167

Abstract

Background

Coronary heart disease develops with high prevalence in the elderly people and i is their main cause of morbidity and mortality. 

Objective

To analyze the influence of comorbidity among the elderly people with myocardial infarction, stratified with the Charlson index and determine if tis presence has to be considered as a risk factor during the in-hospital phase. 

Material and method

We evaluate 375 patients with Q wave myocardial infarction; they were separate in three grupos: group A (<65 years old [90 patients]); group B (66-74 years old [66 patients]), and group C (>75 years old [219 patients]). Each patients was assigned a comorbidity score. 

Results

The global mortality was 23.7%, (10%, 15.5% and 31% for groups A, B and C, respectively). The mortality of the elderly patients treated with thrombolytics was 23.5%; compared to 37.6%, in non-treated patients. When the Charslon score was applied to the patients under thrombolytics treatment those with comorbid conditions presented higher mortality in comparison to those without such states, (45.4% versus 17.5%, p=0.01). In the non-treated patients the presence of comorbid states did not modify rate in the patients with comorbid conditions (41.5% versus 26.6%, p=0.04) regardless the use of thrombolytic therapy. 

Conclusions

Eledery patients presente a higher incidence of comorbid conditions which strongly influence their prognosis. The Charslon index could give the treating physician a numeric index, to allow an informed decision about the convenience of performing or not a reperfusion procedure.