Pharmacologic therapy for acute MI in the elderly

Mortality and morbidity from acute myocardial infarction (MI) are much higher in the elderly than in younger patients, creating a greater potential for improving the outcome with aggressive medical therapy. Elderly patients can benefit significantly from early thrombolysis with relatively few complications; aspirin and heparin-particularly in conjunction with thrombolytic agents-are highly effective. Long-term β-blockade can improve survival markedly, and the use of intravenous angiotensin-converting enzyme inhibitors before discharge decreases both mortality and the risk of heart failure. Early results for magnesium sulfate are promising as well.