The influence of age on health status outcomes after acute myocardial infarction

P. Michael Ho, Marvin H. Eng, John S. Rumsfeld, John A. Spertus, Pamela N. Peterson, Philip G. Jones, Eric D. Peterson, Karen P. Alexander, Edward P. Havranek, Harlan M. Krumholz, Frederick A. Masoudi

Research output: Contribution to journalArticle

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Abstract

Background: Older age is a risk factor for higher mortality after acute myocardial infarction (AMI), but the association with health status outcomes is largely unexplored. Methods: In a prospective cohort of 2498 patients in the PREMIER study, we compared health-related quality of life (HRQL) and burden of angina symptoms among survivors of AMI by age strata (age groups ≥75, 65-74, 50-64, and 19-49 years) using the Seattle Angina Questionnaire. Multivariable analyses assessed the relationship between age and 1-year HRQL and angina burden, adjusting for differences in clinical characteristics, treatment, and baseline health status. Results: Older patients comprised a majority: 20.1% were ≥75 years of age, 41.7% were 65 to 74 years of age, 20.7% were 50 to 64 years of age, and 17.4% were <50 years of age. At 12 months, older patients had higher mortality (17.0% vs 8.7% vs 6.1% vs 3.2% for age groups ≥75, 65-74, 50-64, 19-49; P < .001). Among survivors of AMI, increasing age was associated with less angina and better HRQL. By 12 months, older patients reported less angina (10.9% vs 12.7% vs 19.3% vs 23.4% for age groups ≥75, 65-74, 50-64, 19-49; P < .0001) and better HRQL (scores 89.1 vs 88.1 vs 82.5 vs 80.0, respectively; P < .0001), which persisted after adjustment for baseline angina, HRQL, and other demographic, clinical, disease severity, and treatment differences. Conclusions: Although older patients have higher mortality after AMI, those who survive experience fewer symptoms and better HRQL at 1 year than younger patients. Angina remains present in a number of patients across the spectrum of age, supporting strategies to systematically assess and treat symptoms after AMI.

Original languageEnglish (US)
Pages (from-to)855-861
Number of pages7
JournalAmerican Heart Journal
Volume155
Issue number5
DOIs
StatePublished - May 2008
Externally publishedYes

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Health Status
Myocardial Infarction
Quality of Life
Age Groups
Survivors
Mortality
Demography
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Ho, P. M., Eng, M. H., Rumsfeld, J. S., Spertus, J. A., Peterson, P. N., Jones, P. G., ... Masoudi, F. A. (2008). The influence of age on health status outcomes after acute myocardial infarction. American Heart Journal, 155(5), 855-861. https://doi.org/10.1016/j.ahj.2007.11.032

The influence of age on health status outcomes after acute myocardial infarction. / Ho, P. Michael; Eng, Marvin H.; Rumsfeld, John S.; Spertus, John A.; Peterson, Pamela N.; Jones, Philip G.; Peterson, Eric D.; Alexander, Karen P.; Havranek, Edward P.; Krumholz, Harlan M.; Masoudi, Frederick A.

In: American Heart Journal, Vol. 155, No. 5, 05.2008, p. 855-861.

Research output: Contribution to journalArticle

Ho, PM, Eng, MH, Rumsfeld, JS, Spertus, JA, Peterson, PN, Jones, PG, Peterson, ED, Alexander, KP, Havranek, EP, Krumholz, HM & Masoudi, FA 2008, 'The influence of age on health status outcomes after acute myocardial infarction', American Heart Journal, vol. 155, no. 5, pp. 855-861. https://doi.org/10.1016/j.ahj.2007.11.032
Ho PM, Eng MH, Rumsfeld JS, Spertus JA, Peterson PN, Jones PG et al. The influence of age on health status outcomes after acute myocardial infarction. American Heart Journal. 2008 May;155(5):855-861. https://doi.org/10.1016/j.ahj.2007.11.032
Ho, P. Michael ; Eng, Marvin H. ; Rumsfeld, John S. ; Spertus, John A. ; Peterson, Pamela N. ; Jones, Philip G. ; Peterson, Eric D. ; Alexander, Karen P. ; Havranek, Edward P. ; Krumholz, Harlan M. ; Masoudi, Frederick A. / The influence of age on health status outcomes after acute myocardial infarction. In: American Heart Journal. 2008 ; Vol. 155, No. 5. pp. 855-861.
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AU - Eng, Marvin H.

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AU - Spertus, John A.

AU - Peterson, Pamela N.

AU - Jones, Philip G.

AU - Peterson, Eric D.

AU - Alexander, Karen P.

AU - Havranek, Edward P.

AU - Krumholz, Harlan M.

AU - Masoudi, Frederick A.

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AB - Background: Older age is a risk factor for higher mortality after acute myocardial infarction (AMI), but the association with health status outcomes is largely unexplored. Methods: In a prospective cohort of 2498 patients in the PREMIER study, we compared health-related quality of life (HRQL) and burden of angina symptoms among survivors of AMI by age strata (age groups ≥75, 65-74, 50-64, and 19-49 years) using the Seattle Angina Questionnaire. Multivariable analyses assessed the relationship between age and 1-year HRQL and angina burden, adjusting for differences in clinical characteristics, treatment, and baseline health status. Results: Older patients comprised a majority: 20.1% were ≥75 years of age, 41.7% were 65 to 74 years of age, 20.7% were 50 to 64 years of age, and 17.4% were <50 years of age. At 12 months, older patients had higher mortality (17.0% vs 8.7% vs 6.1% vs 3.2% for age groups ≥75, 65-74, 50-64, 19-49; P < .001). Among survivors of AMI, increasing age was associated with less angina and better HRQL. By 12 months, older patients reported less angina (10.9% vs 12.7% vs 19.3% vs 23.4% for age groups ≥75, 65-74, 50-64, 19-49; P < .0001) and better HRQL (scores 89.1 vs 88.1 vs 82.5 vs 80.0, respectively; P < .0001), which persisted after adjustment for baseline angina, HRQL, and other demographic, clinical, disease severity, and treatment differences. Conclusions: Although older patients have higher mortality after AMI, those who survive experience fewer symptoms and better HRQL at 1 year than younger patients. Angina remains present in a number of patients across the spectrum of age, supporting strategies to systematically assess and treat symptoms after AMI.

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