Immediate and long-term prognosis of acute myocardial infarction in the aged

Librach, G.; Schadel, M; Seltzer, Murray H.; Hart, Anthony; Yellin, N

doi:10.1016/0021-9681(76)90013-8

Cited by 7 publications

(4 citation statements)

References 24 publications

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“…However, abnormality of the electrocardiogram, rather than the symptom of angina with a normal electrocardiogram, is shown to carry an excess mortality, as has been previously shown . The difference in mortality between those with an abnormal electrocardiogram and that expected for the whole group ofsubjects is ofthe same order (1.5 to 2 fold) as was found by Bi6rck et al (1958) and Librach et al (1976) for elderly people discharged from hospital after a myocardial infarct, and is much less than for young or middle-aged patients with ischaemic heart disease.…”

Section: Discussionsupporting

confidence: 77%

“…Of the many 'risk factors' identified with varying degrees of certainty, none, except possibly high blood pressure (Kannel, 1976), has been shown to carry with it an excess risk of ischaemic heart disease in old age (Elmfeldt et al, 1976). Apart from studies of the survival of elderly patients admitted to hospital with acute cardiac infarction (Biorck et al, 1958;Librach et al, 1976), and of the excess mortality associated with a variety of electrocardiographic abnormalities , there is little information on the natural history and prognosis of ischaemic heart disease manifest late in life.…”

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confidence: 99%

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Ischaemic heart disease in the elderly.

Kennedy¹,

Andrews²,

Caird³

1977

Heart

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Studies were made for evidence of heart disease on 501 people aged 65 and more living at home; 22-4 per cent had clinical and/or electrocardiographic evidence of ischaemic heart disease. The prevalence of ischaemic heart disease increased with age, and was slightly greater in men than women. The frequency of ischaemic heart disease increased with increasing current cigarette consumption and with total cigarette consumption. There was no increase in relation to any of the following possible risk factors: systolic and diastolic blood pressure, blood glucose, serum cholesterol, skinfold thickness, percentage of ideal body weight. The survival over a 5-year period of all subjects with ischaemic heart disease did not differ significantly from that of all subjects together, but the mortality of subjects with ischaemic heart disease and an abnormal electrocardiogram was 1-5 to 2 times that of subjects in whom ischaemic heart disease was diagnosed on the basis of angina pectoris or past cardiac infarction, the electrocardiogram being normal.

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Section: Discussionsupporting

confidence: 77%

mentioning

confidence: 99%

Ischaemic heart disease in the elderly.

Kennedy¹,

Andrews²,

Caird³

1977

Heart

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“…Use of digitalis in the hospital seems to be due to reduced cardiac function, which leads to a lower cardiac survival rate. 11,33,40 Patients who had past history of hypertension, angina pectoris, or diabetes mellitus also evidenced a high hazard ratio. Such past history presumably lowered the prognosis of MI.…”

Section: Examination By Multivariate Analysismentioning

confidence: 99%

Influence of risk factors on long‐term survival following acute myocardial infarction: A follow‐up study in central japan

Enomoto

Yamauchi

Hayashi

et al. 1989

Clinical Cardiology

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Summary:The long-term survival rate following acute myocardial infarction (AMI) was studied in 358 patients in central Japan who were monitored for 8 to 20 years after discharge from hospital for AMI. Fifteen-year cardiac survival rates were 65% in males and 72% in females. In both sexes, the survival rate decreased with increasing age at the time of AMI. The survival rate was significantly lower in recurrent MI than in first MI patients. Those who had smoked cigarettes before AM1 or had hyperlipidemia during hospitalization did not show any significant decrease in cardiac survival rate, which may be due to cessation of smoking or control of hyperlipidemia after AMI. The 15-year survival rate was significantly lower in patients with a past history of angina pectoris or hypertension. Patients with a large infarct had a lower survival rate, as did those with a large cardiothoracic ratio on chest x-ray, and those who received digitalis during hospitalization. On the other hand, patients who were administered anticoagulants during hospitalization had a higher survival rate. Multiple regression analysis gave similar results. In conclusion, factors that reduced long-term survival rate after AM1 were older age at time of the first attack, reduced cardiac function, and a history of angina pectoris or hypertension. Anticoagulant therapy appeared to improve the long-term survival rate.

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“…Falls and collapse are a common cause of admission to hospital in elderly patients. Previous studies have demonstrated that acute confusion, syncopal attacks, and giddiness are frequent presenting symptoms in acute myocardial infarction (MI) 1 in the elderly, and often they do not present with classical symptoms of chest pain 1‐3 . Several studies have demonstrated that cardiac arrhythmias are a frequent cause of these symptoms 4,5 but there have been no studies of the incidence of Ml in patients presenting with falls, collapse and confusion.…”

mentioning

confidence: 99%

Screening for Acute Myocardial Infarction in Elderly Patients With Collapse, Confusion and Falls

Phillips

Carroll

Ehsanullah

1999

Int J Clinical Practice

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SUMMARYFalls, collapse and confusion are frequent causes of admission to hospital in the elderly, and myocardial infarction (Ml) can present atypically. The study was designed to assess the incidence of Ml in this group of patients and provide information on the value of screening methods. A total of 142 elderly patients with a mean age of 83 years (range 76‐99) were admitted with unexplained collapse, confusion or falls. Serial ECGs and cardiac enzymes were performed. Eighty‐two patients (59%) had normal ECGs; of these, 80 (98%) had normal or non‐significantly elevated cardiac enzymes; 72/108 patients without chest pain had normal ECGs compared with 10/32 who had chest pain (p<0.01). Cardiac enzymes were elevated in 5/108 without chest pain and 10/32 with chest pain (p<0.01). Thirty‐two (23%) had chest pain, 14 (10%) had an acute Ml. In those presenting with chest pain, 32% had an Ml, compared with only 1.9% of those without chest pain (p<0.01); 18% of patients with an initially abnormal ECG had an Ml compared with only 5% of those with a normal ECG (p=0.02). None of the patients with a normal ECG who were free of chest pain were subsequently proven to have an Ml. Cardiac enzymes are often non‐specifically elevated in this group of patients due to muscle injury. The incidence of Ml is low in patients without chest pain and we would not advocate routine screening with serial cardiac enzymes, unless there is chest pain or an abnormal 12‐lead ECG on admission.

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Immediate and long-term prognosis of acute myocardial infarction in the aged

Cited by 7 publications

References 24 publications

Ischaemic heart disease in the elderly.

Ischaemic heart disease in the elderly.

Influence of risk factors on long‐term survival following acute myocardial infarction: A follow‐up study in central japan

Screening for Acute Myocardial Infarction in Elderly Patients With Collapse, Confusion and Falls

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