[Features of clinical and laboratory parameters in elderly patients with acute coronary syndrome.]
A S Markova1, O T Bogova1, K B Mirzaev1
1Russian Medical Academy of Continuous Professional Education, 2/1 build. 1 Barricadnaya str., Moscow 125993, Russian Federation,
Insights
This study highlights the importance of monitoring triglycerides, glucose, and serum creatinine (sCr) in elderly patients with acute coronary syndrome (ACS). Dynamic sCr assessment improves mortality risk prediction in this population.
Area of Science:
- Cardiology
- Geriatrics
- Clinical Biochemistry
Context:
- Elderly patients are underrepresented in clinical trials for coronary heart disease.
- Limited research exists on acute coronary syndrome (ACS) clinical and laboratory factors in older adults.
- Accurate assessment of biochemical markers is crucial for managing ACS complications and treatment in the elderly.
Purpose:
- To investigate the role of specific clinical and biochemical parameters in the development of ACS in elderly patients.
- To evaluate the predictive value of serum creatinine (sCr) concentration and its dynamic changes for mortality risk in elderly ACS patients.
Summary:
- Triglycerides and glucose play a significant role in ACS development among elderly individuals.
- Assessing the median serum creatinine (sCr) concentration and its daily changes in the coronary care unit reduces mortality risk stratification.
- Daily sCr values and their trends are more potent predictors of hospital mortality in ACS patients than initial sCr levels alone.
Impact:
- Recommends dynamic serum creatinine (sCr) evaluation for more accurate risk stratification in elderly ACS patients.
- Informs clinical practice regarding the management and treatment strategies for ACS in older adults.
- Contributes to a better understanding of age-related differences in ACS pathophysiology and prognosis.
Abstract:
The inclusion of elderly patients in randomized clinical trials does not reflect the age-related association in coronary heart disease. At the same time, there are few scientific papers devoted to clinical and laboratory factors characteristic of the development of acute coronary syndrome (ACS) in this age category. Timely assessment of clinical and biochemical blood parameters in elderly patients is of great importance in preventing complications that naturally increase in them, significantly affects treatment tactics and the possibility of using generally accepted approaches when choosing drug therapy. From these positions, our study showed the special role of triglycerides and glucose in the development of ACS in elderly patients. A joint assessment of the median serum creatinine (sCr) concentration and the nature of its change during stay in the coronary care unit was carried out, which allowed us to conclude that the stratification risk of mortality was reduced. In patients with ACS, the daily value of sCr and the nature of its change are stronger predictors of hospital mortality than only the initial value of sCr. The results of the study suggest that it is recommended to evaluate serum creatinine to ensure a more accurate and dynamic risk stratification in elderly patients with ACS.
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