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Data From the GISSI-2 Database

Tiziano Moccetti, MD; Roberto Malacrida, MD; Elena Pasotti, MD; Fabrizio Sessa, MD; Michele Genoni, MD; Simona Barlera, MS; Fabio Turazza, MD; Aldo P. Maggioni, MD

Arch Intern Med. 1997;157(8):865-869.

Abstract
Background
Acute myocardial infarction in younger patients is uncommon, occurring mainly in men. The recent introduction of thrombolysis improved survival, left ventricular function, and infarct size.

Objective
To evaluate characteristics and clinical outcome of the patients younger than 50 years randomized in the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico study. All patients received a thrombolytic treatment.

Methods
The 11 483 patients were divided into 3 age subgroups: younger than 50 years (17.2%), between 50 and 70 years (60.2%), and older than 70 years (22.6%). All relations between variables were first determined by an unadjusted analysis. An adjusted analysis was performed by multiple logistic regression models for inhospital and 6-month mortality.

Results
While older patients had a significantly higher rate of a history of hypercholesterolemia, diabetes, and hypertension, smoking and a positive family history were significantly more frequent in younger patients. Total inhospital and 6-month mortality were significantly lower in patients younger than 50 years (2.7% and 1.2%, respectively) than in patients between 50 and 70 years old (6.9% and 2.7%) and those older than 70 years (21.1% and 8.4%). After multivariate analysis, the predictive value of age was confirmed.

Conclusions
Our findings, based on a large group of patients who received thrombolytic treatment, suggest that younger age is a significant independent indicator of a favorable prognosis after acute myocardial infarction.

Arch Intern Med. 1997;157:865-869

Author Affiliations
for the Investigators of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI-2)

From the Medical Department, Civil Hospital, Lugano, Switzerland (Drs Moccetti, Malacrida, Pasotti, Sessa, and Genoni); and Istituto di Ricerche Farmacologiche M. Negri, Milan, Italy (Ms Barlera and Drs Turazza and Maggioni). A complete list of the investigators and centers participating in GISSI-2 has been published elsewhere.14

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