ST-elevation myocardial infarction risk in the very elderly
Alessandra M Campos1, Andrea Placido-Sposito2, Wladimir M Freitas2
1Cardiology Department, State University of Campinas (Unicamp), Campinas, SP, Brazil; Pharmaceutical Sciences Department, Faculty of Health Sciences, University of Brasília (UnB), Brasília, DF, Brazil.
BBA Clinical
|September 17, 2016
Summary
In individuals aged 80+, low HDL-C, reduced GFR, male gender, smoking, and depression indicate higher risk for ST-segment elevation myocardial infarction (STEMI). Conventional factors like diabetes and hypertension are less significant in this age group.
Area of Science:
- Cardiology
- Geriatrics
- Public Health
Background:
- ST-segment elevation myocardial infarction (STEMI) has high incidence and mortality in the very elderly.
- Risk markers for STEMI in this population are poorly understood.
Purpose of the Study:
- To identify independent risk markers for STEMI in individuals aged 80 years or older.
Main Methods:
- A case-control study involving 50 STEMI patients and 207 healthy elderly individuals (≥80 years).
- Data collected included blood tests, medical, and psychological evaluations.
- Multivariate regression models were used to determine Odds Ratios (OR) and attributed risk (AR).
Main Results:
- Low glomerular filtration rate (GFR) [OR:4.41]
- Reduced high-density lipoprotein cholesterol (HDL-C) [OR:10.70]
- Male gender [OR:12.08]
- Moderate to severe depressive symptoms [OR:10.00]
- Prior [OR:2.00] and current smoking [OR:6.58] were significantly associated with STEMI.
- No association found with age, diabetes, hypertension, mild depressive symptoms, triglyceride, or LDL-C.
Conclusions:
- Low HDL-C, reduced GFR, male gender, smoking, and moderate to severe depressive symptoms are key STEMI risk markers in the very elderly.
- Attention should focus on these markers, rather than traditional factors like diabetes and hypertension, for STEMI risk assessment in individuals aged 80+.
Keywords:
ANCOVA, analysis of covarianceAR, attributable riskAgedAged, 80 and overBDI-II, Beck Depression Inventory version IIBHS, Brasília Heart StudyBSHA, Brasília Study on Healthy AgingCK-MB, MB fraction of creatine kinaseCRP, C-reactive proteinCVD, cardiovascular diseaseDBP, diastolic blood pressureEDTA, ethylenediamine tetraacetic acidGDS, Geriatric Depression ScaleGFR, glomerular filtration rateHDL-C, high-density lipoprotein cholesterolHDL-cholesterolHbA1c, glycated hemoglobinIQR, interquartile rangeLDL-C, low-density lipoprotein cholesterolMI, myocardial infarctionMyocardial infarctionOR, odds ratioSBP, systolic blood pressureSD, standard deviationSTEMI, ST-segment elevation myocardial infarctionMore Related Videos
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