In the past, corrective invasive procedures used after a heart attack (acute myocardial infarction [AMI]) were not commonly offered to patients over 80 as they were judged to be too risky. However, this practice is changing. The trend today for these invasive procedures, such as revascularization, is now more common in patients of this age group as they contribute to an increased survival rate that greatly outweighs the perceived risk.
This is according to Dr. Louise Pilote, researcher in epidemiology at the Research Institute of the MUHC (RI MUHC), who in collaboration with colleagues at the University of Montreal and the Jewish General Hospital, has just published these results in the Canadian Medical Association Journal.
“We now believe that the increase in revascularization procedures such as angioplasty and bypass surgery in patients aged 80 and over, is responsible for the decrease in mortality rate,” says Dr. Pilote, who is also director of the Division of Internal Medicine at the MUHC and professor of Medicine at McGill University.
The 10-year study, which involved nearly 30,000 patients from Quebec, shows an increase of more than 20 percent of angioplasty and a decline in mortality rate. Another interesting aspect of this research is it brings the relationship of our ageing population and healthcare management to the forefront.
“Our results lead us to predict that in the near future more and more of these types of invasive procedures will be used,” says Dr. Pilote. “The challenge now lies in making available human and financial resources within the health system to support this new approach.”
The research received funding from the Canadian Institutes of Health Research (CIHR)
The article “Temporal Trends in Revascularization and Outcomes after Acute Myocardial Infarction in the Very Elderly” was co-authored by Maude Pagé (first author) and Michel Doucet, Division of Cardiology, Department of Medicine, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal; Mark J. Eisenberg, Divisions of Cardiology and Clinical Epidemiology, Department of Medicine, Jewish General Hospital, McGill University, Montreal; Hassan Behlouli and Louise Pilote, Divisions of Internal Medicine and Clinical Epidemiology, McGill University Health Centre and McGill University, Montreal.