Age and Mortality and Morbidity in ST-Segment Elevation Myocardial Infarction

Abstract

Advanced age is a powerful independent predictor of in-hospital and subsequent mortality and morbidity in patients following an ST-elevation myocardial infarction (MI) (, , , ). Randomized studies including thousands of patients with ST-segment elevation MI indicate 10-fold increases in death, clinical heart failure, and cardiogenic shock following either thrombolytic or primary angioplasty as age increases from younger than 60 to older than 85 years, with an exponential rise in both in-hospital and 6-month post-discharge mortality (, , , ). Public health data indicate that nearly 85% of all deaths from coronary disease in the United States occur in individuals older than 65 years of age (), and that cardiac disease is the leading cause of death in older Americans, which is the most rapidly growing segment of the US population.