Clinical Characteristics And Risk Factors Of In-hospital Mortality In Old Patients With Acute Myocradial Infarction

Background:Advanced age remains one of the principal determinants of mortality in patients with acute myocardial infarction (AMI).Objective: To evaluate risk factors, baseline characteristics, coronary angiography features and in-hospital outcomes in patients who are 60 yrs and older with AMI.Methods:203 patients 60 yrs and older with AMI and underwent percutaneous coronary intervention(PCI) registried in The First Affiliated Hospital of Soochow University between January 2008 and June 2010 were compared according to age categorized in 6 groups:60-64,65-69,70-74,75-79,80-84,and 85 and older.Results: 184(90.6%) patients were ST segment elevated myocardial infarction(STEMI).81.3% patients'heart function grade arrived in hospital was Killip I. There was no difference between each group in gender, diabetes mellitus, old myocardial infarction, stroke, heart function, diseased vessels, reperfusion, complication and in-hospital mortality. Constituent ratio of female and stroke morbidity both have direct correlation with age. In patients 60 yrs and older, female with high total cholesterol (8.8%vs 1.8%,p<0.05) and low-density lipoprotein cholesteral(8.8%vs 1.8%,p<0.05) were more common than male,so was in-hospital mortality(14.7%vs 5.3%,p<0.05).Multivariate analysis revealed that female, diabetes mellitus, Killip grade, left ventricular ejection fraction(LVEF),amount of diseased vessels are risk factors of in-hospital mortality, the OR of female is 5.585,diabetes mellitus is 5.023,1.908 of per grade of Killip class accrescenced,3.327 of adding per diseased vessel,and 1.1408 of per 5% LVEF diminished.Conclusion:Constituent ratio of female and stroke morbidity both have direct correlation with age. The proportion of high total cholesteral and low-density poprotein cholesteral was higher in female than male, also with in-hospital mortality. In old patients with AMI, female, diabetes mellitus, Killip grade, left ventricular ejection fraction(LVEF),amount of diseased vessels are risk factors of in-hospital mortality.