Heart attack drug 'could kill elderly'

Drugs given to millions of heart attack patients may place some at greater risk of death, according to research.

Over-80s who received "clot busting" drugs were 40% more likely to die in hospital, compared with those who did not receive the drugs.

The findings reinforce previous studies which have identified a link between thrombolytic drugs - given immediately after heart attacks to dissolve clots in the blood vessels serving the heart - and increased mortality in the elderly.

"We wouldn't want to say thrombolytics wouldn't be suitable for people over the age of 75 and we wouldn't want to see an age limit set "

British Heart Foundation spokeswoman

Researchers examined the records of 2,659 heart attack patients admitted to 37 community hospitals in the Minnesota region of the USA between 1992 and 1996.

Of this group, 719 patients were eligible for thrombolytic therapy.
In the study, published in the Archives of Internal Medicine, about 63% of eligible heart attack patients received the drugs.

The therapy reduced deaths among eligible patients younger than 80, but increased mortality in older people.

Elderly dangers
For the entire patient group, the risk of death associated with thrombolytic therapy rose 4% for each year above 65.

The researchers said: "Findings of this study suggest a need to re-assess our approach to the use of thrombolytic therapy in the treatment of acute myocardial infarction patients older than 75 years."

They say there are several reasons why elderly patients may not share the benefits of thrombolytic therapy seen in younger patients.

The risk of bleeding and stroke are markedly increased in elderly people and they tend to experience longer delays between symptom onset and hospitalisation - that substantially reduce the drugs' effect on survival.

However, the British Heart Foundation (BHF) has strong reservations about the research.

A BHF spokeswoman said: "We don't really agree with this study.

"For someone who is eligible for it, it's fantastic and could stop them from dying, but for others it could be dangerous.

"There is no age limit on thrombolytics although people who are older are more likely to be at risk from other factors, but we wouldn't want to say thrombolytics wouldn't be suitable for people over the age of 75 and we wouldn't want to see an age limit set."

BBC News Online