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Article
April 3, 1991

Coronary Thrombolysis for the Elderly?

Author Affiliations

Dr Gurwitz is a recipient of a fellowship in geriatric clinical pharmacology from the American Federation for Aging Research and the Merck Foundation.
From the Program for the Analysis of Clinical Strategies of the Department of Medicine, and the Geriatric Research and Training Center, Harvard Medical School and Beth Israel Hospital, Boston, Mass (Dr Gurwitz); the Hebrew Rehabilitation Center for Aged, Boston, Mass (Dr Gurwitz); and the Department of Medicine, University of Massachusetts Medical School, Worcester (Drs Goldberg and Gore).

Dr Gurwitz is a recipient of a fellowship in geriatric clinical pharmacology from the American Federation for Aging Research and the Merck Foundation.
From the Program for the Analysis of Clinical Strategies of the Department of Medicine, and the Geriatric Research and Training Center, Harvard Medical School and Beth Israel Hospital, Boston, Mass (Dr Gurwitz); the Hebrew Rehabilitation Center for Aged, Boston, Mass (Dr Gurwitz); and the Department of Medicine, University of Massachusetts Medical School, Worcester (Drs Goldberg and Gore).

JAMA. 1991;265(13):1720-1723. doi:10.1001/jama.1991.03460130112032
Abstract

CARDIOVASCULAR disease ranks as the leading cause of disability and death in the elderly. Although those 65 years of age or older constitute only 13% of the US population,1 80% of all deaths due to acute myocardial infarction (MI) occur in those over the age of 65 years. Of these, 60% occur in patients 75 years of age or older.2 The in-hospital case-fatality rate for initial acute MI increases from 5% in those less than 55 years of age to 32% in those older than age 75.3 Patient age at the time of onset of acute MI also affects survival after hospital discharge.4 For example, results of the Worcester Heart Attack Study indicate a 94% 1-year survival rate among patients with acute MI who are less than 55 years of age and are discharged alive from the hospital, compared with only 77% for those 75 years

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