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. 2013 Jun;4(2):134-9.
doi: 10.1016/j.jcdr.2012.08.005. Epub 2013 Jun 21.

Age and clinical outcomes in patients presenting with acute coronary syndromes

Emad Ahmed  1 , Khalid F Alhabib, Ayman El-Menyar, Nidal Asaad, Kadhim Sulaiman, Ahmad Hersi, Wael Almahmeed, Alawi A Alsheikh-Ali, Haitham Amin, Ahmed Al-Motarreb, Shukri Al Saif, Rajvir Singh, Jawad Al-Lawati, Jassim Al Suwaidi
Affiliations

Age and clinical outcomes in patients presenting with acute coronary syndromes

Emad Ahmed et al. J Cardiovasc Dis Res. 2013 Jun.

Abstract

Context: Elderly patients have more cardiovascular risk factors and a greater burden of ischemic disease than younger patients.

Aims: To examine the impact of age on clinical presentation and outcomes in patients presenting with acute coronary syndrome (ACS).

Methods and material: Collected data from the 2nd Gulf Registry of Acute Coronary Events (Gulf RACE-2), which is a prospective multicenter study from six adjacent Arab Middle Eastern Gulf countries. Patients were divided into 3 groups according to their age: ≤50 years, 51-70 years and >70 years and their clinical characteristics and outcomes were analyzed. Mortality was assessed at one and 12 months.

Statistical analysis used: One-way ANOVA test for continuous variables, Pearson chi-square (X (2)) test for categorical variables and multivariate logistic regression analysis for predictors were performed.

Results: Among 7930 consecutive ACS patients; 2755 (35%) were ≤50 years, 4110 (52%) were 51-70 years and 1065 (13%) >70 years old. The proportion of women increased with increasing age (13% among patients ≤50 years to 31% among patients > 70 years). The risk factor pattern varied with age; younger patients were more often obese, smokers and had a positive family history of CAD, whereas older patients more likely to have diabetes mellitus, hypertension, and dyslipidemia. Advancing age was associated with under-treatment evidence-based therapies. Multivariate logistic regression analysis after adjusting for relevant covariates showed that old age was independent predictors for re-ischemia (OR 1.29; 95% CI 1.03-1.60), heart failure (OR 2.8; 95% CI 2.17-3.52) and major bleeding (OR 4.02; 95% CI 1.37-11.77) and in-hospital mortality (age 51-70: OR 2.67; 95% CI 1.86-3.85, and age >70: OR 4.71; 95% CI 3.11-7.14).

Conclusion: Despite being higher risk group, elderly are less likely to receive evidence-based therapies and had worse outcomes. Guidelines adherence is highly recommended in elderly.

Keywords: Acute coronary syndrome; Age; Elderly.

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Figures

Fig. 1
Fig. 1
Hospital, 1-month and 12-month mortality in patients presenting with acute coronary syndrome according to age groups.
See this image and copyright information in PMC

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