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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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Clinical features of acute myocardial infarction in elderly patients

Teruo Shiraki1, Daiji Saito

  • 1Department of Cardiology, Iwakuni Clinical Center, National Hospital Organization, Iwakuni, Yamaguchi 740-8510, Japan. shiraki@iwakuni-nh.go.jp

Acta Medica Okayama
|December 23, 2011
PubMed

Insights

Elderly patients with acute myocardial infarction show distinct clinical features, including higher in-hospital mortality. Factors like high-sensitivity C-reactive protein (hs-CRP) and atrial fibrillation predict mortality in this age group.

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Internal Medicine

Background:

  • Coronary risk factors and prognostic indicators in elderly patients with acute myocardial infarction (AMI) require clarification.
  • Understanding age-specific characteristics of AMI is crucial for effective prevention and treatment strategies.

Purpose of the Study:

  • To determine the prevalence of coronary risk factors in elderly AMI patients.
  • To identify prognostic factors influencing outcomes in this demographic.
  • To discover factors beneficial for preventing recurrent cardiac events and mortality.

Main Methods:

  • Retrospective analysis of 888 patients with ST-elevation AMI admitted within 48 hours of symptom onset.
  • Patients categorized into three age groups: ≤50 years, 51-69 years, and ≥71 years.
  • Comparison of clinical variables, risk factors, and outcomes across age groups using statistical analysis, including multiple regression.

Main Results:

  • Elderly patients (≥71 years) exhibited higher rates of female gender, pulmonary congestion, in-hospital mortality, and atrial fibrillation, along with elevated high-sensitivity C-reactive protein (hs-CRP).
  • Middle-aged patients (51-69 years) had higher prevalence of hypertension, diabetes mellitus, and dyslipidemia.
  • Elderly patients had lower prevalence of smoking and lower levels of total cholesterol, LDL-cholesterol, and triglycerides, but the highest collateral circulation grade and lowest reperfusion therapy success rate.
  • Multiple regression identified age, pulmonary congestion, chronic kidney disease (CKD), and hs-CRP as predictors of in-hospital mortality.

Conclusions:

  • Elderly patients with AMI present with unique clinical characteristics compared to younger individuals.
  • Age, pulmonary congestion, CKD, and hs-CRP are significant predictors of in-hospital mortality in AMI patients.
  • A tailored management algorithm for elderly AMI patients, potentially incorporating hs-CRP, estimated glomerular filtration rate (eGFR), and atrial fibrillation, may be necessary.

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