Does increasing age impact clinical presentation and hospital mortality in patients with acute coronary syndromes?
Elderly patients with ACS have significantly higher in-hospital mortality and are less likely to present with ST-elevation, yet they receive less intensive investigation and reperfusion treatment.
AIMS: Age is one of the most powerful determinants of prognosis in myocardial infarction, but there is comparatively little recent data across the whole spectrum of acute coronary syndromes (ACS). We examined the impact of increasing age on clinical presentation and hospital outcome in a large sample of patients with ACS. METHODS AND RESULTS: Patients (n = 10 253) from the Euroheart ACS survey in 103 hospitals in 25 countries were investigated. There was a significant inverse association between the age and the likelihood of presenting with ST-elevation. For each decade of life, the odds of presenting with ST-elevation decreased by 0.82 95% confidence interval (CI) 0.79-0.84; P or =85 years, with no major differences across different types of admission or discharge diagnoses. CONCLUSION: Elderly ACS patients were less likely to present with ST-elevation but had substantial in-hospital mortality, yet they were markedly less intensively treated and investigated.
Rosengren et al. (Tue,) studied this question.
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