Independent predictors of in-hospital and 1-year mortality rates in octogenarians with acute myocardial infarction

Abstract

Older age is known as a negative prognostic parameter in acute myocardial infarction (AMI) patients. In this study, we aimed to explore age-associated differences in treatment protocols, in-hospital and 1-year mortality. This cohort observational study included 277 consecutive AMI patients, separated into 2 groups according to whether their age was ≥80 years or not. We found that group I patients (aged ≥80 years) had a notably lower rate of percutaneous coronary intervention (PCI) performed (P < 0.0001) and a notably higher inhospital death rate (P < 0.003). The multivariate logistic regression analysis found that three variables were independent predictors of in-hospital mortality: age ≥80 years (P < 0.0001), LVEF <40% (P < 0.0001), and Killip class ≥3 (P < 0.0001). The 1-year death rate was again significantly higher in group I patients (P < 0.001) and was independently predicted by the triple-vessel coronary artery disease (P = 0.004) and an LVEF <40% at admission (P = 0.001). The 1-year readmission rate was superior in group I (P < 0.01) and independently predicted by an age ≥80 years (P < 0.001), and an history of congestive heart failure (P < 0.0001) or permanent atrial fibrillation (P < 0.001). We concluded that patients aged ≥80 benefit less often from a PCI and have higher rates of in-hospital mortality, as well as of 1-year readmission and mortality rates.

Comparison of in-hospital and long-term mortality and assessment of their predictors in patients with myocardial infarction and unstable angina

“…Снижение сократительной функции ЛЖ -признанный предиктор неблагоприятных исходов как в госпитальном, так и в отсроченном периоде ИМ. ФВ ЛЖ < 40% ассоциируется с повышением уровня госпитальной летальности [14]. В работе, включившей 2353 пациента с ИМпST, ФВ < 30%, наряду с многососудистым поражением коронарных артерий, передней локализацией ИМ, желудочковыми тахиаритмиями и баллом по шкале Killip ≥ 2, выступала независимым предиктором госпитальной летальности [15].…”

Monocyte to high-density lipoprotein ratio is associated with mortality in patients with coronary artery diseases

“…In this study, the monocyte to high-density lipoprotein ratio was an independent predictor of all-cause mortality and in-hospital complications in patients with CAD, especially in patients with hypertension. Older age and poor heart function were the main predictors of in-hospital mortality [ 31 ], but whether other factors were also crucial for the short-term prognosis following CAD was unclear due to the complicated pathological mechanisms after disease onset. To provide additional evidence, we performed a cohort study with a relatively large sample size.…”

Safety and efficacy of perioperative continuous renal replacement therapy for percutaneous coronary intervention in severe acute myocardial infarction patients

“…The prognosis of acute myocardial infarction (AMI) patients has significantly improved due to early diagnosis, advances in therapeutic strategies, and widespread use of emergency operations [10]. However, some patients still experience poor outcomes, often due to delayed opening of blocked vessels, serious coronary lesions, or multiple organ dysfunction.…”