Prognosis of octogenarian patients with acute myocardial infarction –a nationwide analysis from the Hungarian Myocardial Infarction Registry

Abstract

Little literature data is available regarding the frequency of the optimal treatment among the octogenarian myocardial infarction patient. The authors investigated the incidence of oldest old patients, comorbidities, hospital treatment   and life expectancy of them in a nationwide, mandatory Hungarian Myocardial Infarction Registry (HUMIR). Between 1 January 2010 and 31 December 2015, 55910 AMI patients were registered. At the time of hospital admission, 8065 (14.4%) patients were aged 80 years or older. This was the cohort group for the present analysis. All patients were followed for one year using the national death database. The average age were 84.8 ± 3.95 years. The major part of the whole patient population was a woman (59.5 %), and more old patients (59.7 %) were treated with the diagnosis of  non-ST-elevation myocardial infarction (NSTEMI). The comorbidities were more frequent in the NSTEMI patient group compared to the ST-elevation myocardial infarction (STEMI) patients. In the STEMI patient population 69% of them underwent coronary angiography, in the case of 61 % primary percutaneous coronary intervention (PCI) was also carried out. In the case of 50.5 % of the patients with NSTEMI coronarography was done, at the same time, the rate of the catheter revascularisation was only 36 %. The thirty day and one-year mortality was higher in STEMI group comparing NSTEMI patients regardless of PCI. The STEMI and NSTEMI patients with PCI have better survival at thirty days and one year comparing to whole patient group with the same diagnosis: STEMI 20.6%, 34.2% vs.  28.9% and 43.6% and NSTEMI 10.4% and 22.5% versus 21.6% and 34.2%.  Conclusions: In an unselected myocardial infarction patient population, a high number of oldest old patients were found. Octogenarian patients treated with PCI have better short and long term prognosis comparing to patients without revascularization.