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EBSCO

https://doi.org/10.14300/mnnc.2023.18001

Myocardial infarction in nonagenarians: peculiarities of the clinical course, management, outcomes

[Original research] [Internal diseases]
Kristina Gennadievna Pereverzeva; Anna Sergeevna Galas; Peregudova Natalia; Sergey Stepanovich Yakushin; Irina Vladimirovna Budanova;

Our objective was to study and analyze the peculiarities of the clinical course, diagnosis, management, treatment and outcomes in nonagenarians (≥90 years) with myocardial infarction (MI).

The research included 82 patients aged ≥90 years, who were discharged from two cardiological centres in Ryazan in the period from January 1, 2015 to December 31, 2020, with MI. 23.2 % of those patients was men (19). Median of all patients – 91 (90; 93) years old.

The most common complaints were: weakness, anginal pain and dyspnea. 42.7 % (35) of patients had the elevation of ST segment on the electrocardiogram. Thrombolytic therapy was performed in 2.4 % (2) of cases, coronary angiography in 8.5 % (7) of patients, and 7.3 % (6) patients were stent. The development of complications of myocardial infarction was observed in 80.5 % (66) of patients. Intrahospital mortality rate was 40.2 % (33).

The factors associated with a lower risk of in-hospital death are the prescription of angiotensin-converting enzyme inhibitors and sartans (relative risk 0.13 with a 95 % confidence interval from 0.04 to 0.46; p=0.002), with a large risk of death –development of cardiogenic shock (relative risk 4.67 with a 95 % confidence interval from 1.27 to 17.13; p=0.02).

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Keywords: myocardial infarction, nonagenarians, outcomes, cardiogenic shock, percutaneous coronary intervention