In-Hospital Outcomes of Patients Older Than 65 Years of Age with Acute Myocardial Infarction in the Central Asian Region

CLINICAL RESEARCH
Aleksey G. Nikishin, PhD*, Ravshanbek D. Kurbanov, PhD, ScD, Mahmudjon M. Pirnazarov, PhD, Yayra Askarova

Republican Specialized Center of Cardiology, Tashkent, Uzbekistan

*Corresponding author: Aleksey G. Nikishin, PhD, Department of Acute Myocardial Infarction, Republican Specialized Center of Cardiology, 4, Osiyo str., 100052, Tashkent, Uzbekistan. Tel.: 998-97-119-6133. E-mail: angdoc@yandex.ru

Abstract: 

Background: To detect distinctive features of the clinical course for acute myocardial infarction (AMI), treatment tactics, and clinical outcomes in elderly patients of the Central Asian region.

Methods: The study included 508 patients who were assigned into two groups: Group 1 consisting of patients older than 65 years of age with AMI and Group 2 consisting of those younger than 65 years. The mean time from AMI onset to hospital admission was studied, as well as the number of patients admitted during the first 6 hours after onset, the number of patients treated with streptokinase and its efficacy, clinical course of AMI, and in-hospital outcomes.

Results: The mean time for hospital admission in the group of patients older than 65 years was significantly longer than in the control group: 1220±165 min versus 977±88 min (p<0.05). Out of 188 patients with ST segment elevation who were older than 65 years, only 14.3% received streptokinase compared to 25.5% in the control group where 149 patients had ST segment elevation. The clinical picture of AMI in both the study groups did not differ significantly. The groups were reliably distinguished by in-hospital mortality (9.4% against 2.86%; p=0.001; odds ratio (OR) 3.53 (1.43-8.67)), frequency of acute heart failure occurrence (33.89% versus 21.9%; p=0.001; OR 1.83 (1.22-2.74), and chronic heart failure development (41.31% versus 24.76%; p=0.000; OR 2.62 (1.78-3.86)).

Conclusion: The main problem in elderly patients is a lower probability in achieving myocardial reperfusion (due to delay in seeking medical help and lower efficacy of thrombolytic therapy) and a higher occurrence of heart failure as a result.

Keywords: 
acute myocardial infarction, elderly, in-hospital outcome, duration of hospitalization.
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Int J Biomed. 2011; 1(2):79-83.© 2011 International Medical Research and Development Corporation. All rights reserved.