Longevity and frailty and their associated factors in the prognosis of coronary heart disease in a Latin American cohort

Abstract

Introduction to study the characteristics of the anamnestic history, the clinical course, as well as the nature of medical care for elderly patients with acute myocardial infarction (MI) and evaluate their impact on the prognosis of the disease. Material and methods the study included patients aged 60 years or older, survivors of acute myocardial infarction and registered in the database of the Hospital Universitario de los Andes in Merida, Venezuela (n=410). During the 2013-2018 study, a five-year prospective observation of patients with an assessment of their vital status was conducted. For the statistical processing of the data obtained, the Statistica V10.0 application package (StatSoft Inc.) was used. Results the analysis showed that 90% of the patients had a history of comorbid pathology. The presence of an atypical manifestation of myocardial infarction lengthened the prehospital stage of medical care for patients who were late in seeking medical attention (120 [49; 311.5] minutes), as well as the longest time until the first medical contact (26.5 [20; 40] minutes (p = 0.005)). One-fifth of patients were treated for acute MI in complementary hospitals, where the level of in-hospital mortality among elderly patients reached 65.7%, three times higher than the same figure in specialized cardiology departments (19, 7%, p< 0.001). Conclusion The main factors influencing long-term post-infarction in elderly patients were isolated systolic arterial hypertension, diabetes mellitus, renal dysfunction, previous myocardial infarction and acute stroke.