Advanced age and risk factors for acute myocardial infarction

: This case-control study, analyzed the role of coronary risk factors in acute myocardial infarction (AMI) in the elderly, and established the nature of this association and the degree of risk. Data were derived from an investigation (1060 cases and 1071 controls) conducted in 35 coronary care units from clinical centres in Argentina between November 1991 and August 1994. Our analysis was based on data collected from subjects over age 65. Cases were 427 patients with AMI and without history of ischaemic heart disease. Controls were 396 subjects identified in the same centres as the cases. Odds ratios (OR) estimates and their 95% confidence intervals (CI) were derived from multiple logistic regression equations including terms for age, education, social status, smoking status, history of diabetes or hypertension, body mass index and family history of coronary heart disease. The risk factors independently and strongly related to the risk of AMI were the following: hyperlipidemia (serum cholesterol > or = 240 mg/dl): OR = 1.76 (95% CI: 1.25-2.49), smoking habits: OR = 1.6 (95% CI: 1.06-2.4), hypertension: OR = 2.05 (95% CI: 1.51-2.73), diabetes OR = 1.71 (95% CI: 1.12-2.70), one relative with family history of coronary heart disease: OR = 1.36 (95% CI: 0.93-1.97) and two or more relatives: OR = 2.63 (95% CI: 1.21-5.71). This study confirms in the elderly the importance of hyperlipidemia, tobacco, hypertension, diabetes and family history of coronary heart disease as risks factors of AMI.