Magnitude and impact of multiple chronic conditions with advancing age in older adults hospitalized with acute myocardial infarction

Int J Cardiol. 2018 Dec 1;272:341-345. doi: 10.1016/j.ijcard.2018.08.062. Epub 2018 Aug 22.


Background: To examine age-specific differences in the frequency and impact of cardiac and non-cardiac conditions among patients aged 65 years and older hospitalized with acute myocardial infarction (AMI).

Methods: Study population consisted of 3863 adults hospitalized with AMI at 11 medical centers in central Massachusetts on a biennial basis between 2001 and 2011. The presence of 11 chronic conditions (five cardiac and six non-cardiac) was based on the review of hospital medical records.

Results: Participants' median age was 79 years, 49% were men, and had an average of three chronic conditions (average of cardiac conditions: 2.6 and average of non-cardiac conditions: 1.0). Approximately one in every two patients presented with two or more cardiac related conditions whereas one in every three patients presented with two or more non-cardiac related conditions. The most prevalent chronic conditions in our study population were hypertension, diabetes, heart failure, chronic kidney disease, and peripheral vascular disease. Patients across all age groups with a greater number of previously diagnosed cardiac or non-cardiac conditions were at higher risk for developing important clinical complications or dying during hospitalization as compared to those with 0-1 condition.

Conclusions: The prevalence of multimorbidity among older adults hospitalized with AMI is high and associated with worse outcomes that should be considered in the management of this vulnerable population.

Keywords: Multiple chronic conditions; Myocardial infarction.

Publication types

  • Observational Study

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Electronic Health Records / trends
  • Female
  • Hospitalization / trends*
  • Humans
  • Male
  • Multiple Chronic Conditions / epidemiology*
  • Multiple Chronic Conditions / therapy*
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / epidemiology*
  • Myocardial Infarction / therapy*
  • Risk Factors