Thrombolysis for acute myocardial infarction in patients over 75 years.

Authors: Fade, P.Z. and Allen, S.C.

Journal: CME Journal Geriatric Medicine

Volume: 3

Issue: 1

Pages: 7-9

ISSN: 1367-8914

Abstract:

Patients over 75 years account for 50% of deaths from acute myocardial infarction. The absolute mortality in elderly patients is much higher than in the young. Potentially they have the most to gain from proven interventions. The evidence from a meta-analysis of randomised controlled trials suggests a beneficial effect for thrombolysis in the elderly; saving 10 lives per 1000 treated, but the result is not statistically significant. The risk of stroke after thrombolysis increases significantly with age. Indirect evidence in favour of thrombolysis comes from retrospective studies of mortality pre and post the introduction of thrombolysis. However, a recent restrospective study of outcome after AMI, from America casts doubt on the efficacy of thrombolysis in the elderly suggesting it may have an adverse effect on outcome.

Source: Scopus