Elderly MI patients routinely denied thrombolytic therapy

Despite the fact that thrombolytic therapy can dramatically reduce the risk of mortality for patients with acute myocardial infarction (MI), a new report indicates that fewer than half of all elderly MI patients ever receive the treatment.

The report, published in the July 28 issue of The Journal of the American Medical Association, was prepared by researchers at the Yale University School of Medicine in New Haven, CT, who studied 3,093 MI patients age 65 and older. Of those patients, 753 qualified for treatment but did not receive thrombolytics because of their age or a possible risk of bleeding. Of the 261 identified by the researchers as ideal candidates for thrombolytic therapy, one-quarter were not treated.

Thrombolytic therapy is associated with an 18% reduction in the risk of death for MI patients, according to the researchers, who contend that the possible benefits tend to outweigh concerns over the possibility of bleeding.

(See: Krumholz HM, Murillo JE, Chen J, et al. Thrombolytic therapy for eligible elderly patients with acute myocardial infarction. JAMA 1997; 21:1683-1688.)