P008 COMPARISON OF CLINICAL OUTCOME OF ELDERLY (AGED >65 YEARS) VS NON-ELDERLY HYPERTENSIVE STEMI PATIENTS: RESULTS FROM NAMI REGISTRY

Abstract

Background and Objective: Elderly hypertensive ST-segment elevation myocardial infarction (STEMI) patients had increased morbidity and mortality. Little is known regarding clinical outcome of elderly hypertensive STEMI patients worldwide. This study aimed to compare clinical outcome of elderly and non-elderly hypertensive STEMI Bangladeshi patients. Methods: This prospective observational study- National Heart Foundation Hospital Acute Myocardial Infarction (NAMI) Registry was carried out in our hospital over eight years (2015-2022). All hypertensive STEMI patients were included in this study. Clinical outcome of elderly (aged >65 years) and non-elderly (aged ≤65 years) patients were compared. Results: NAMI registry enrolled 10488 STEMI patients. Among them 6890 (65.69%) patients were hypertensive and included in this study. Of them 1127 (16.4%) patients were elderly, and 5763 (83.6%) patients were non-elderly. The mean age of the elderly patients was 72.93 ± 5.5 years and non-elderly patients 52.54 ± 8.69 years. Although male were predominant in both groups (79.3% vs 85.0%; p=0.001), significantly more female were in elderly group (20.7% vs 15.0%; p=0.001). Most of the elderly patients had chronic kidney disease (85.1% vs 41.3%; p=0.001). Most of the non-elderly patients were smokers (52.8% vs 41.3%; p=0.001), dyslipidemic (81.1% vs 76.0%; p=0.001), and obese (38.8% 31.4%; p=0.001). Elderly patients received less invasive therapy (thrombolytic therapy- 14.3% vs 19.0%, p=0.002; primary percutaneous coronary intervention- 10.6% vs 11.6%; pharmaco-invasive therapy-5.9% vs 11.4%, p=0.001; only percutaneous coronary intervention- 18.4% vs 20.0%) and more medical therapy (50.9% vs 38.1%; p=0.001). Elderly patients were more prone to complications (cardiogenic shock- 14.8% vs 10.8%, p=0.001; acute left ventricular failure- 33.9% vs 22.7%, p=0.001; conduction disturbance- 15.2% vs 9.7%, p=0.001; arrhythmias- 13.1% vs 8.2%, p=0.001; cardiac arrest-7.5% vs 4.7%, p=0.001; in-hospital death- 7.9% vs 4.2%, p=0.001). Conclusions: Most of the elderly hypertensive STEMI patients had chronic kidney disease, less risk factor, received less invasive therapy but more medical therapy and were more prone to complications in comparison to younger counterpart.