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50. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds)
12. Jahrestagung der Deutschen Arbeitsgemeinschaft für Epidemiologie (dae)

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie
Deutsche Arbeitsgemeinschaft für Epidemiologie

12. bis 15.09.2005, Freiburg im Breisgau

Guideline based treatment of 5079 patients (<=/>75years) with acute myocardial infarction of the Berlin Myocardial Infarction Registry

Meeting Abstract

  • Birga Maier - Berliner Herzinfarktregister e.V., Berlin
  • Jochen Schuler - Vivantes Humboldt Klinikum, Berlin
  • Gerd Kallischnigg - Institut für Gesundheitswissenschaften der TU, Berlin
  • Steffen Behrens - Vivantes Humboldt Klinikum, Berlin

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie. Deutsche Arbeitsgemeinschaft für Epidemiologie. 50. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 12. Jahrestagung der Deutschen Arbeitsgemeinschaft für Epidemiologie. Freiburg im Breisgau, 12.-15.09.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05gmds243

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/gmds2005/05gmds092.shtml

Veröffentlicht: 8. September 2005

© 2005 Maier et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background

Incidence and mortality of acute myocardial infarction (AMI) increases with age. In Berlin 26% of patients with acute myocardial infarction are older than 75 years but 53% of those who die are over 75years. How does therapy differ between younger and old patients and may thereby influence prognosis? [1], [2]

Methods

Between 1999 and 2003 data of 5079 patients with acute myocardial infarction were prospectively collected from 25 hospitals in Berlin. 1319 pts were older than 75 years. We present clinical, treatment and outcome data of these two populations.

Results

The overall infarct mortality rate is 11.6%. In the patients > 75years mortality rate is 23.7%, in the younger ones 7.3%. Some differences in their treatment are shown in Tab 1. [Tab. 1]

In a multivariate analysis the following independent predictors of hospital mortality for patients > 75years were calculated: age in years (OR=1.06), pre-existing heart failure (OR=2.38), pre-hospital cardiopulmonary resuscitation (OR=10.6), and cardiogenic shock (OR=2.73) on admission, admission to a hospital with > 600 beds (OR=0.64) and time between onset of symptoms and hospital arrival >12h (OR=1.68), ST elevation in initial ECG (OR=2.09), reperfusion therapy (OR=0.64), as well as beta-blocker (OR=0.47) and ACE inhibitor treatment (OR=0.49) within 48h after hospitalization.

Discussion

Despite well known benefits reperfusion therapy and betablockers on admission are underused in patients with acute myocardial infarction over 75yrs. This undertreatment may influence, at least in part, the prognosis in this high risk subgroup of patients. [3], [4], [5], [6]


References

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2.
Lee PY, Alexander KP, Hammill BG, Pasquali SK, Peterson ED. Representation of elderly pesons and women in published randomized trials of acute coronary syndromes. JAMA 2001: 286 (6): 708-713
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