Clinical features of acute myocardial infarction in elderly patients.
Shiraki T, Saito D.
Department of Cardiology, Iwakuni Clinical Center, National Hospital Organization, Iwakuni, Yamaguchi 740-8510,
Japan.shiraki@iwakuni-nh.go.jp.
Acta Med Okayama. 2011 Dec;65(6):379-85.Abstract
The aim of this study was to clarify the prevalence of coronary risk factors in order to characterize the prognostic factors in elderly patients and to also identify any factors beneficial for the prevention of further cardiac events and death. We studied 888 patients with ST-elevation acute myocardial infarction who were admitted within 48h of symptom onset. The patients were divided into 3 groups according to age for comparison of variables:a younger group (n＝99) aged＜50, a middle-aged group (n＝435)＞51 years but＜70 years and an elderly group (n＝354) aged＞71 years. The elderly group had higher rates of female gender, pulmonary congestion, in-hospital mortality, and atrial fibrillation and a higher plasma concentration of high-sensitivity CRP (hs-CRP) (p＜0.05). Hypertension, diabetes mellitus, and dyslipidemia were more common in the middle-aged group (p＜0.05). The prevalence of smokers and the plasma level of total cholesterol, LDL-cholesterol and triglycerides were lower in the elderly group (p＜0.05). The grade of collateral circulation was highest in the elderly group, but the success rate of reperfusion therapy was lowest. Multiple regression analysis showed that age, pulmonary congestion, CKD and hs-CRP were predictors of in-hospital mortality.This investigation indicated that elderly patients with acute myocardial infarction have different clinical characteristics than younger patients. A specific algorithm might be needed in elderly patients, and could use hs-CRP, eGFR and atrial fibrillation as factors.
http://www.lib.okayama-u.ac.jp/www/acta/pdf/65_6_379.pdf 
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