Acute myocardial infarction in the elderly: differences by age

J Am Coll Cardiol. 2001 Sep;38(3):736-41. doi: 10.1016/s0735-1097(01)01432-2.


Objectives: We evaluated the clinical characteristics and outcomes of elderly patients hospitalized with acute myocardial infarction (AMI) to describe differences by age.

Background: Elderly patients with AMI are perceived as a homogeneous population, though the extent by which clinical characteristics vary among elderly patients has not been well described.

Methods: Data from 163,140 hospital admissions of Medicare beneficiaries age > or =65 years between 1994 and 1996 with AMI at U.S. hospitals were evaluated for differences in clinical characteristics and mortality across five age-based strata (in years): 65 to 69, 70 to 74, 75 to 79, 80 to 84 and > or =85.

Results: Older age was associated with a greater proportion of patients with functional limitations, heart failure, prior coronary disease and renal insufficiency and a lower proportion of male and diabetic patients. Of note, the proportion of patients presenting with chest pain within 6 h of symptom onset, and with ST-segment elevation, was lower in each successive age group. Thirty-day mortality rates were higher in older age groups (65 to 69: 10.9%, 70 to 74: 14.1%, 75 to 79: 18.5%, 80 to 84: 23.2%, > or =85: 31.2%, p = 0.001 for trend). The effect of age persisted but was attenuated after adjustment for differences in patient characteristics; similar trends were observed for one-year mortality.

Conclusions: Our data indicate significant age-associated differences in clinical characteristics in elderly patients with AMI, which account for some of the age-associated differences in mortality. The practice of grouping older patients together as a single age group may obscure important age-associated differences.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Male
  • Myocardial Infarction / epidemiology*
  • Myocardial Infarction / mortality
  • Odds Ratio
  • United States / epidemiology