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May 3, 1995

Catheterization and Mortality in Elderly Patients With Acute Myocardial Infarction

JAMA. 1995;273(17):1332-1333. doi:10.1001/jama.1995.03520410025015

To the Editor.  —I read with great interest the recent article by Dr McClellan and colleagues1 regarding the treatment of AMI in the elderly. McClellan et al are to be commended for their novel approach to the analysis of outcomes after an AMI. While they concluded that there was only a modest and possibly no true incremental effect of catheterization and associated revascularization procedures on mortality after an AMI in the elderly, they failed to mention a key point regarding the issue of age itself and AMI. While it has been reported that the in-hospital mortality after AMI in the elderly can be as high as 17.8% for patients aged 75 years and older and 2% for those aged 55 years and younger,2 Smith et al3 have reported age itself not to be an independent risk factor for mortality after an AMI. We presented data on 208

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