Introduction: cardiovascular diseases are the main cause of death in Chile, being acute
myocardial infarction (AMI) the most frequent. Its incidence increases with age, so, as
the population gets older; a higher number of cases is expected. Despite this, AMI within
octogenarian patients (OP) has been understudied in our country and worldwide; there are
no specific guidelines for their management, only a few isolated studies that reveal the poor
applicability of the standard treatments indicated in AMI clinical guidelines. Objective: To
describe the clinical features, initial treatment, in-hospital evolution and five-year outcome of
OP with AMI, and compare them to patients under 80 years of age. Method: Consecutive
registration of all patients diagnosed with AMI that were hospitalized in our coronary unit
between 1988 and 2007. Description of clinical features, in-hospital and 5-year evolution of
all OP cases. Comparison to the younger group of patients through chi-square or t-student
tests, considering p-value <0.05 as statistically significant. Results: 1851 AMI patients were
registered within this period, of which 135 (7,3%) were OP. The mean age was 83,7 years
(80-100), 59% chronic hypertension, 22% diabetes, 11% smokers, 44% had history of angina
and 13% previous AMI. The mean evolution time was 10 hours (80% <12 hours), 67% had ST-
segment elevation (STE), 56% anterior-wall AMI. 29% underwent reperfusion therapy, and 64%
presented AMI complications, mainly cardiac insufficiency. Coronarography was performed to
42% of OP, 33% were revascularized. In-hospital mortality was 29%, mainly because of cardiac
insufficiency, 5-year mortality was 52.1%. Compared to younger patients, OP account for more
female cases, higher Killip-scores, less STE-AMI, receive less reperfusion therapy and early
beta-blockers, have more complications, are less studied and revascularized, and have higher
mortality rates. Conclusion: OP have initial characteristics that configure greater severity to
AMI. Besides, they are treated more conservatively, having a worse in-hospital evolution along
with higher early and 5-year mortality. We suggest that this conservative behavior accounts for
an important part of the unfavorable outcomes among OP, according to the few international
studies available on this topic.
Ugalde P., H. ., Sanhueza F., M. I. ., Yubini L., M. C. ., & Rozas A., S. . (2016). Infarto agudo al miocardio en octogenarios, caracterización y comparación con pacientes menores en 20 años de registro. Revista Hospital Clínico Universidad De Chile, 27(3), pp. 198–205. https://doi.org/10.5354/2735-7996.2016.70886
