Acute Myocardial Infarction: Clinical Characteristics, Management and Outcome in a Metropolitan Veterans Affairs Medical Center Teaching Hospital
Journal of the American College of CardiologyPublished 1 April 1997
Judith K. Mickelson, Cynthia M Blum, Jane M. Geraci
Citations45
SJR quartileQ1
SJR score9.02
SNIP6.30
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TL;DR
The use of thrombolytic agents and invasive treatment plans declined with age, and mortality increased with age; trends toward increased mortality occurred with non-Q wave infarctions and race other than Caucasian.
Abstract
The use of thrombolytic agents and invasive treatment plans declined with age, and mortality increased with age. Trends toward increased mortality occurred with non-Q wave infarctions and race other than Caucasian.
Keywords
Medicine
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