Comparative study between elderly and younger patients with acute coronary syndrome

Background

Acute coronary syndrome (ACS), one of the commonest causes of ICU admission, casts a large burden of cost on the health care system, with a huge mortality in the elderly, in Egypt and worldwide.

Objectives

Comparative study between elderly and younger patients with acute coronary syndrome in the last 4 years in the Critical Care department, Cairo University.

Patients

The population of the study included 570 patients who were admitted to the Critical Care department, Cairo University with ACS (between January 2011 and February 2015). Patients were divided into two groups: (1) Elderly ⩾ 60 year. (2) Younger < 60 year.

Methods

Data collection focused on patients’ demographics; risk factors for CAD, PCI indications; baseline cardiac status & associated medical conditions; angiographic & PCI procedure and clinical success of PCI.

Results

Dyslipidemia, hypertension and diabetes were the most significant risk factors for ACS in elderly (p < 0.001), while smoking was the most significant risk factor in younger patients (p < 0.001). Predictors of heart failure were age and TIMI score. Being elderly increases odds ratio of heart failure by 3.154 times, (P value .035), also increases in TIMI score increase the incidence of heart failure by 0.825 times, (P value <.001). Mortality was frequent in elderly than younger, (P value = 0.002).

Conclusion

Dyslipidemia, hypertension and diabetes were the most frequent risk factors for CAD in elderly, while smoking was the most frequent risk factor in younger patients. Mortality was more frequent in elderly than younger. Complications were more frequent in elderly than younger. A predictor of Heart failure was an increase in both age and TIMI score.