Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2000 Nov;23(11):831-6.
doi: 10.1002/clc.4960231109.

In-hospital mortality of elderly patients with acute myocardial infarction: data from the MITRA (Maximal Individual Therapy in Acute Myocardial Infarction) registry

K K Haase  1 , R Schiele, S Wagner, F Fischer, U Burczyk, R Zahn, S Schuster, J Senges
Affiliations
Comparative Study

In-hospital mortality of elderly patients with acute myocardial infarction: data from the MITRA (Maximal Individual Therapy in Acute Myocardial Infarction) registry

K K Haase et al. Clin Cardiol. 2000 Nov.

Abstract

Background: Advanced age remains one of the principal determinants of mortality in patients with acute myocardial infarction (AMI).

Hypothesis: The aim of this study was to determine the in-hospital outcome of elderly (> 75 years) patients with AMI who were admitted to hospitals participating in the national MITRA (Maximal Individual Therapy in Acute Myocardial Infarction) registry.

Methods: MITRA is a prospective, observational German multicenter registry investigating current treatment modalities for patients presenting with AMI. All patients with AMI admitted within 96 h of onset of symptoms were included in the MITRA registry. MITRA was started in June 1994 and ended in January 1997. This registry comprises 6,067 consecutive patients with a mean age of 65 +/- 12 years, of whom 1,430 (17%) were aged > 75 years. Patients were compared with respect to patient characteristics, prehospital delays, early treatment strategies, and clinical outcome.

Results: In the elderly patient population, the prehospital delay was 210 min, which was significantly longer than that for younger patients (155 min, p = 0.001). Although the incidence of potential contraindications for the initiation of thrombolysis was almost equally distributed between the two age groups (8.7 vs. 8.2%, p = NS), elderly patients (> 75 years) received reperfusion therapy less frequently (35.9 vs. 64.6%) than younger patients. Mortality increased with advanced age and was 26.4% for all patients aged > 75 years. If reperfusion therapy was initiated, in-hospital mortality was 21.8 versus 28.9% in patients aged > 75 years (p = 0.001) and 29.4 versus 38.5% in patients aged > 85 years (p = 0.001).

Conclusion: In this registry, elderly patients with AMI had a much higher in-hospital mortality than that expected from randomized trials. In MITRA, the mortality reduction with reperfusion therapy was found to be highest in the very elderly patient population.

PubMed Disclaimer

References

    1. Maggioni A, Maseri A, Fresco C, Franzoni MG, Mauri F, Santoro E, Togoni G: Age‐related increase in mortality among patients with first myocardial infarction treated with thrombolysis. N Engl J Med 1993; 329: 1442–1448 - PubMed
    1. Guadagnoli E, Hauptman PJ, Ayanian JZ, Pashos CL, McNeil BJ, Cleary PD: Variation in the use of cardiac procedures after acute myocardial infarction. N Engl J Med 1995; 333: 573–578 - PubMed
    1. Ketley D, Woods KL: Impact of clinical trials on clinical practice: Example of thrombolysis for acute myocardial infarction. Lancet 1993; 342: 891–894 - PubMed
    1. Gruppo Italiano per lo Studiodella Streptochinasi nell'Infarto Miocardico (GISSI) : Long‐term effects of intravenous thrombolysis in acute myocardial infarction: Final report of the GISSI study. Lancet 1987; 871–874 - PubMed
    1. ISIS‐2 : Randomized trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS‐2. Lancet 1988; 2: 349–360 - PubMed

Publication types