Clinical Characteristics And Treaments Among Patients Hospitalized With Acute Myocardial Infarction

Object:To investigate the clinical characteristics across all age groups and analyse theinfluences of age on the evidence-based therapies and short prognosis.Methods：The eligible patients during the recruitment period from2014.01.01to2014.06.30were stratified into3age categories, then differences in gender, pastmedical history, vital signs, treatments, complications and the in-hospital prognosiswere assessed.Results:�'�In this study，30.8percentage of patients were women, but this proportionincreased with age. The prevalence of coronary heart disease increased withadvancing age, too. The prevalence of hypertension and stroke、 non-ST-segmentelevation MI and the incidence of cardiac insufficiency were significantly higher inthe aged group, whereas smoking was significantly higher in the youth group. Theyouth group had less admission delay. According to the coronary angiography，increases of Gensini score、the incidence of triple vessels and left main lesion werenoted in the aged group. On the contrary， the incidence of single vessel lesiondecreased with age.2. The reperfusion rate was above70%in both the youth and middle agedgroup， which was significantly higher than the aged group. The difference wasattributed to the higher rate of emergency PCI in the youth and middle aged group.The use of aspirin、clopidogrel、low molecular weight heparin and statins were highacross all age groups(above95%overall)， except for angiotensin-convertingenzyme(ACE) inhibitor/angiotensin receptor blocker (63.7%) and beta blockers(54.3%). Less than45%patients were prescribed5-drug combination therapy(aspirin，clopidogrel，β-blocker, ACE inhibitor/angiotensin receptor blocker and statins) and2-drug combination therapy (β-blocker and ACE inhibitor/angiotensinreceptor blocker).3.Overall，there were more complications and worse prognosis in the aged group.Specifically，atrial fibrillation and pneumonia were more common in the aged group.With the increase of age, the in-hospital mortality increased significantly，with pumpfailure the most important cause of death.Conclusion:1.Compared to the younger patients with AMI,the older patients had morecomorbidities and complications, but were less likely to receive evidence-basedtherapies and had worse in-hospital prognosis.2.There is much to do to improve the evidence-based therapies in clinicalpractice, especially in the older patients.