老人 急性 心筋梗塞의 長期 豫後; ST-分節 上昇과 ST-分節 非上昇 心筋梗塞 間의 豫後 差異

Abstract

Background & objectives Recently, elderly patients with acute myocardial infarction (AMI) are increasing rapidly, and some of them presented as non-ST elevation myocardial infarction (NSTEMI), but their long-term clinical outcomes are not well-defined in Korea.

Methods From Nov 1st 2005 to Dec 31st 2008, 239 patients with AMI admitted to our hospital. They were divided into four aged groups; ≥75 (group 1; n=60, 79.8±4.4), 65-74 (group 2; n=62, 69.6±3.0), 50-64 (group 3; n=72, 57.0±3.9), <50 years old (group 4; n=45, 43.9±5.0).

Results More patients with group 1 were women and non-smokers, and complained of atypical chest pain. Serum NT-proBNP level was higher, and hospital stays were longer in the group 1. Doppler echocardiographic study of the mitral inflow showed less restrictive filling pattern in the group 1. Previous histories of DM and ischemic heart disease, Killip classification, maximal CK-MB and troponin T level, left ventricular EF, and proportions of NSTEMI were not different among groups. 1-year survival, and major adverse cardiac event (MACE)-free survival were not significantly different (p=0.17, and 0.92, respectively). Subgroup analysis of patients with ST-elevation MI (STEMI) showed the lowest 1-year survival rate of group 1 (p=0.0067), but not patients with NSTEMI (p=0.46).

Conclusions Elderly patients with AMI showed somewhat different clinical manifestations. Long-term survival rate was lower only in STEMI. Elderly patients with NSTEMI had similar long-term clinical outcomes.