Wiener klinische Wochenschrift

, Volume 130, Issue 5–6, pp 172–181 | Cite as

Impact of age on short- and long-term mortality of patients with ST-elevation myocardial infarction in the VIENNA STEMI network

  • Paul Michael Haller
  • Bernhard Jäger
  • Serdar Farhan
  • Günter Christ
  • Wolfgang Schreiber
  • Franz Weidinger
  • Thomas Stefenelli
  • Georg Delle-Karth
  • Alfred Kaff
  • Gerald Maurer
  • Kurt Huber
original article
  • 85 Downloads

Summary

Background and aim

Our senescent society includes a growing number of elderly people suffering from ST-elevation myocardial infarction (STEMI); however, exactly this population is often underrepresented in randomized trials. Hence, our aim was to investigate the influence of age on patient characteristics, as well as short- and long-term outcome in the Vienna STEMI registry.

Methods

We included all patients of the Vienna STEMI registry (2003–2009). Patients were stratified into age cohorts (≤45, 46–59, 60–79 and ≥80 years, respectively). Differences between cohorts were investigated by descriptive statistics and regression models. Crude and adjusted mortality rates were investigated using log rank test and Cox regression models, respectively. The influence of treatment on mortality was further investigated using propensity score matching.

Results

A total of 4579 patients fulfilled the criteria for further investigation. With rising age of cohorts, the number of females, diabetes mellitus (DM), hypertension (HTN), previous myocardial infarction (MI), shock, no reperfusion therapy and anterior wall infarction significantly increased. In contrast, the number of patients with a positive family history, smoking and hyperlipidemia (HLP) significantly declined. Log rank analysis showed significant differences between age cohorts for short- and long-term mortality. Cox regression analysis for short-term mortality revealed an independent association for age at the event, HTN and shock, while age, smoking, DM, HTN, HLP, previous MI and shock independently influenced long-term mortality after correction for confounders. Also, we found a significant association of age and total ischemic time (TIT), which however had no influence on long-term mortality (interaction term p = 0.236). Propensity score matching revealed reduced mortality rates for patients who received reperfusion therapy compared to conservative management, irrespective of age.

Conclusions

Increasing age independently influenced short- and long-term mortality in patients with STEMI in the Vienna STEMI network. The TIT significantly increased with baseline age, but had no impact on mortality. Furthermore, reperfusion therapy exerted beneficial effects irrespective of the patients’ age.

Keywords

STEMI Age Mortality Total ischemic time 

Notes

Funding

This work was supported by the Association for Research on Arteriosclerosis, Thrombosis and Vascular Biology (ATVB) and the Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna.

Compliance with ethical guidelines

Conflict of interest

P.M. Haller, B. Jäger, S. Farhan, G. Christ, W. Schreiber, F. Weidinger, T. Stefenelli, G. Delle-Karth, A. Kaff, G. Maurer, and K. Huber declare that they have no competing interests.

Ethical standards

The study was performed according to the 1964 Helsinki declaration and its later amendments and was approved by the local ethics committee.

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Copyright information

© Springer-Verlag GmbH Austria 2017

Authors and Affiliations

  • Paul Michael Haller
    • 1
    • 9
  • Bernhard Jäger
    • 1
    • 9
  • Serdar Farhan
    • 1
    • 9
  • Günter Christ
    • 2
    • 9
  • Wolfgang Schreiber
    • 3
    • 9
  • Franz Weidinger
    • 4
    • 9
  • Thomas Stefenelli
    • 5
    • 9
  • Georg Delle-Karth
    • 6
    • 9
  • Alfred Kaff
    • 7
    • 9
  • Gerald Maurer
    • 8
    • 9
  • Kurt Huber
    • 1
    • 9
  1. 1.3rd Medical Department, Cardiology and Intensive Care MedicineWilhelminenhospitalViennaAustria
  2. 2.5th Medial Department, CardiologySozialmedizinisches Zentrum SüdViennaAustria
  3. 3.Department of Emergency MedicineMedical University of ViennaViennaAustria
  4. 4.2nd Medical Department, CardiologyKrankenhaus RudolfstiftungViennaAustria
  5. 5.1st Medical Department, CardiologySozialmedizinisches Zentrum OstViennaAustria
  6. 6.4th Medical Department, CardiologyKrankenhaus HietzingViennaAustria
  7. 7.Ambulance Services ViennaViennaAustria
  8. 8.Department of CardiologyMedical University of ViennaViennaAustria
  9. 9.Vienna STEMI Registry GroupViennaAustria

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