Age related differences in acute coronary syndrome presentation and in hospital outcomes: a cross-sectional comparative study

Coronary artery disease is prevalent worldwide and causing much morbidity and mortality, it causes 12.7% of death across the earth; the burden is involving all countries and communities . Elderly patients with thee acute coronary syndrome are at particular risk of death and morbidity, 83% of acute coronary syndrome mortality occur in patients ≤65 years. We aimed to assess age-related differences in acute coronary syndrome presentation, management, and in-hospital complications. A comparative cross-sectional study conducted at a coronary care unit in Omdurman Teaching Hospital, Sudan. The study included 202 patients older than 18 years with the diagnosis of the acute coronary syndrome from July 2014-August 2015. Patients were invited to sign a written informed consent, and then a case report form including demographic data, hypertension, diabetes, smoking, prior myocardial infarction, reperfusion therapy, and in-hospital complications was filled. The ethical committee of Omdurman Teaching Hospital approved the research, and the Statistical Package for Social Sciences was used with P-value of < 0.05 considered significant. Comparison between patients below 50 years and those aged 50 or older was undertaken using the chi-square test. Older patient with the acute coronary syndrome were more likely to be hypertensive (57.6%vs.41.4%), had heart failure ( 56.2%vs,37.2%), presented to hospital>12 hours after onset of pain, less likely to receive thrombolytic therapy (9.2%vs. 23.5%), and had more in-hospital complications (64.2%vs.45.1%) P-value < 0.05. No statistical differences were evident between young and old patients regarding coronary risk factors, coronary angiography, and hypotension P-value > 0.05. Elderly acute coronary syndrome patients were more likely to have hypertension, heart failure, and in-hospital complications, they presented later to the hospital, and less likely to benefit from thrombolytic therapy.