The Characteristics of Clinical Presentation and In-hospital Outcome of Acute Myocardial Infarction Patients Older than 65 Years of Age

Abstract

Background:The aging of the patient population is one of the most important factors influencing health care delivery. Currently 5% of the Korean population is elderly, defined as older than 65 years of age, with this group projected to increase to 13.1% by the year 2021. Cardiovascular disease is the leading cause of death and of disability in the elderly age group. Among them, coronary heart disease is the most important. Method:Study population composed of 216 patients who were admittied to the hospital with first acute myocardial infarction and they were divided into two groups according to the age(older than 65 years of age vs younger). Clinical features, risk factors of coronary heart disease, in-hospital outcome and complication were compared in elderly patients and others group. Results: 1) The risk factors of coronary heart disease is similar to younger patients but pattern of chest pain is less typical than younger patients. 2) Clinical presentation of elderly patients is similar to younger patients except Killip class on admission.(1.66 vs 1.91, p=0.04) 3) In-hospital mortality of elderly patients in higher than younger patients. In addition to an increased incidence of death, recurrent ischemia, stroke, AV block, ventricular arrythmia, pulmonary edema occured more frequently with advanced age. 4) Especially in the thrombolytic therapy group, in-hospital death, reinfarction and recurrent ischemia is higher than primary PTCA group in elderly patients. Conclusions:Diagnosis of acute chest pain is difficult in elderly patients and in-hospital mortality and morbidity is higher than in younger patients. Thus more accurate diagnosis and discriminative therapeutic modality is needed.