Pattern of cardiovascular risk factors and outcomes of patients older than 80 years and presenting with acute coronary syndromes

Abstract

Abstract Background Elderly patients presenting with acute coronary syndrome (ACS) are at a higher risk for morbidity, complications and early mortality than younger patients. Elderly are frequently underrepresented in clinical trials. Methods A descriptive multi-center study including 760 patients admitted with ACS in order to determine the most frequently encountered cardiovascular risk factors, as well as the in-hospital complications among this age group. Results Of the 760 patients, 42.1% were males with a mean age of 85 years. Non-ST-elevation ACS was encountered in 496 patients (65.3%; NSTEMI 50% and unstable angina 15.3%) while STEMI was encountered in 264 patients (34.7%). Regarding risk factors, 61.1% of patients were hypertensive, 60% were diabetics, 44.7% were smokers, 28.9% had dyslipidemia, 16.8% had a family history of coronary artery disease, and 20% had chronic renal impairment at presentation. 252 patients (33.2%) underwent primary PCI, 440 patients (57.9%) underwent elective PCI, 36 patients (4.7%) underwent coronary artery bypass graft (CABG) surgery while 32 patients (4.2%) were maintained on conservative medical therapy and no patients received fibrinolytic therapy. In-hospital mortality was only 3.7% (28 patients), cerebrovascular stroke occurred in 16 patients (2.1%) and recurrent infarction occurred only in 8 patients (1.1%). Conclusions In patients over 80 years presenting with ACS, female sex, hypertension and diabetes were the most frequently encountered cardiovascular risk factors, with more frequent presentation of NSTEMI than STEMI and in-hospital mortality of 3.7%. Funding Acknowledgement Type of funding sources: None.