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Thrombolytics 'underused' in the elderly

Thrombolytic agents appear to be 'underused' in elderly patients with acute myocardial infarction (MI), say US-based researchers.

They reviewed the medical records of 3824 patients with acute MI who were admitted to hospitals in Worcester, Massachusetts, US, in 1986, 1988, 1990, 1991 and 1993.

The researchers found 'marked age-related trends in the use of thrombolytic therapy'. In each time period, younger patients were significantly more likely to receive thrombolytic therapy, and patients aged ~ 7S years were least likely to receive thrombolytic therapy.

Use in elderly historically low Over time, 'the most striking increases in the use

of thrombolytic therapy' were in the elderly, but this in part reflects the low utilisation rate of thrombolytics in patients aged ~ 6S years in 1986, note the researchers.

Even after controlling for various confounding factors, patients aged ~ 7S years were significantly less likely to receive thrombolytic therapy compared with younger patients.

Room for improvement The researchers comment that there is 'considerable

room for improvement in physicians' use of these agents in carefully selected elderly patients', especially as the use of thrombolytics in the elderly with acute MI has been demonstrated to be not only beneficial but also cost effective.

Chandra H, Yanebski J. Goldberg RJ. Savageau J, Singleton C. et al. Age-related

trends (1986-1993) in the use of thrombolytic agents in patients with acute

myocardial infarction: the Worcester Hean Attack study. Archives of Internal Medicine 157: 74 J. 746, 14 Apr 1997 .,.,,,'"

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