Background: Mortality is very high in elderly patients with acute myocardial infarction (AMI). However, the influence on the onset of heart failure (HF) after first-time AMI hasn't been investigated. Methods: We evaluated 870 consecutive patients admitted with first-time AMI visiting hospital within 24 hours of onset. Patients were divided into the age groups young: < 60 years, old: 60 to 80 years, and very old: > 80 years and were evaluated for clinical management and onset of HF. Results: Those with young, old, and very old comprised 243, 454, and 173 patients, respectively. As compared with young, old/very old groups were characterized by higher percentage of female, higher BNP, lower EF and lower rate of revascularization. In-hospital mortality was significantly high in the very old patients. The symptom-to-door time was the longest in the very old group. Kaplan-Meier analysis revealed that very old groups was highest rate of onset of HF. After adjustment with patient background, in comparison with old group, young group was found to be independently associated with lower rate of the onset of HF (adjusted HR, 0.30; 95% CI: 0.09 to 0.82, P = .02), while very old group was higher (adjusted HR, 2.58; 95% CI: 1.22–5.39, P = .01). Conclusion: In the very old patients, the risk of development of HF is very high after their first AMI.
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