First-ever syncope incidence peaks at 15 and 70 years, with early-onset characterized by vasovagal syncope and late-onset by orthostatic hypotension and carotid sinus syndrome.
What are the differences in incidence patterns and underlying mechanisms between early-onset and late-onset syncope?
Syncope incidence follows a bimodal age distribution, with distinct underlying mechanisms (VVS in young vs. OH/CSS in older patients) that can guide clinical evaluation.
Absolute Event Rate: 0% vs 0%
AIMS: Unexplained syncope is an important clinical challenge. The influence of age at first syncope on the final syncope diagnosis is not well studied. METHODS AND RESULTS: Consecutive head-up tilt patients (n = 1928) evaluated for unexplained syncope were stratified into age groups 1 concurrent diagnosis; 14 vs. 26%, P < 0.001) were more common in late-onset syncope. In patients aged ≥60 years, 12% had early-onset and 70% had late-onset syncope; older age at first syncope was associated with higher odds of OH (+31% per 10-year increase, P < 0.001) and CSS (+26%, P = 0.004). Younger age at first syncope was associated with the presence of prodromes (+23%, P < 0.001) and the diagnoses of VVS (+22%, P < 0.001) and complex syncope (+9%, P = 0.018). CONCLUSION: In patients with unexplained syncope, first-ever syncope incidence has a bimodal lifetime pattern with peaks at 15 and 70 years. The majority of older patients present only recent syncope; OH and CSS are more common in this group. In patients with early-onset syncope, prodromes, VVS, and complex syncope are more common.
Torabi et al. (Wed,) reported a other. First-ever syncope incidence peaks at 15 and 70 years, with early-onset characterized by vasovagal syncope and late-onset by orthostatic hypotension and carotid sinus syndrome.