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<p>Evidence on cardiac remodeling, left ventricular (LV) function recovery, medication use and outcomes in older ST-segment elevation myocardial infarction (STEMI) patients is limited. We examined these aspects at baseline and evolution one year post-infarct in patients aged ≥ 80 versus &lt; 80.STEMI registry data were retrospectively analyzed. The older subgroup included patients aged ≥ 80 years at index hospitalization. Echocardiography was performed at baseline and one year after STEMI. LV remodeling was defined as &gt; 20% relative increase in the LV end-diastolic volume. One-year cardiovascular outcomes and five-year all-cause mortality are reported.Study included 2178 patients; 132 (6.1%) were aged ≥ 80. Older patients had worse baseline LV ejection fraction (47.2 ± 9.6% versus 49.8 ± 8.2%; <i>p</i> &lt; 0.001) and experienced more adverse LV remodeling (29% versus 19%; <i>p</i> = 0.024). Nevertheless, LV function improved similarly in both groups. Beta-blocker and renin-angiotensin-aldosterone system inhibitor use was lower (86.4% versus 94.2%; <i>p</i> &lt; 0.001 and 90.2% versus 96.5%; <i>p</i> &lt; 0.001, respectively) but diuretic prescription higher (18.2% versus 8.1%; <i>p</i> &lt; 0.001) in older patients. One year post-infarct beta-blocker and renin-angiotensin-aldosterone system inhibitor use decreased and was similar in both groups, but older patients continued to receive more diuretics and suffered higher heart failure hospitalization rates (7.0% versus 2.6%; <i>p</i> = 0.006). Five-year mortality was 25.8% in older versus 4.3% in younger patients (log-rank χ2 133.2; <i>p</i> &lt; 0.001).Older patients experienced more adverse LV remodeling, received less beta-blockers and renin-angiotensin-aldosterone system inhibitors but more diuretics at discharge and one year, compared to younger patients. Nevertheless, LV function recovered similarly in both groups.</p>

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ST-segment elevation myocardial infarction in older adults: echocardiographic characterization and outcomes in contemporary practice

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月11日

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  • Laima Caunite,
  • Rinchyenkhand Myagmardorj,
  • Xavier Galloo,
  • Dorien Laenens,
  • Jan Stassen,
  • Takeru Nabeta,
  • Idit Yedidya,
  • Maria Chiara Meucci,
  • Jurrien H. Kuneman,
  • Inge J. van den Hoogen,
  • Sophie E. van Rosendael,
  • Hoi W. Wu,
  • Victor M. van den Brand,
  • Adrian Giuca,
  • Karlis Trusinskis,
  • Nina Ajmone Marsan,
  • Jeroen J. Bax,
  • Pieter van der Bijl

摘要

Evidence on cardiac remodeling, left ventricular (LV) function recovery, medication use and outcomes in older ST-segment elevation myocardial infarction (STEMI) patients is limited. We examined these aspects at baseline and evolution one year post-infarct in patients aged ≥ 80 versus < 80.STEMI registry data were retrospectively analyzed. The older subgroup included patients aged ≥ 80 years at index hospitalization. Echocardiography was performed at baseline and one year after STEMI. LV remodeling was defined as > 20% relative increase in the LV end-diastolic volume. One-year cardiovascular outcomes and five-year all-cause mortality are reported.Study included 2178 patients; 132 (6.1%) were aged ≥ 80. Older patients had worse baseline LV ejection fraction (47.2 ± 9.6% versus 49.8 ± 8.2%; p < 0.001) and experienced more adverse LV remodeling (29% versus 19%; p = 0.024). Nevertheless, LV function improved similarly in both groups. Beta-blocker and renin-angiotensin-aldosterone system inhibitor use was lower (86.4% versus 94.2%; p < 0.001 and 90.2% versus 96.5%; p < 0.001, respectively) but diuretic prescription higher (18.2% versus 8.1%; p < 0.001) in older patients. One year post-infarct beta-blocker and renin-angiotensin-aldosterone system inhibitor use decreased and was similar in both groups, but older patients continued to receive more diuretics and suffered higher heart failure hospitalization rates (7.0% versus 2.6%; p = 0.006). Five-year mortality was 25.8% in older versus 4.3% in younger patients (log-rank χ2 133.2; p < 0.001).Older patients experienced more adverse LV remodeling, received less beta-blockers and renin-angiotensin-aldosterone system inhibitors but more diuretics at discharge and one year, compared to younger patients. Nevertheless, LV function recovered similarly in both groups.