Age Differences in Acute Chest Pain Care in a Multisite US Cohort
Nicklaus P Ashburn1, Anna C Snavely1,2, Lyle Paukner1,2
1Department of Emergency Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Clinical Cardiology
|April 21, 2026
Summary
Older adults with chest pain face higher risks of death, myocardial infarction (MI), and hospitalization within 30 days. This risk persists even after accounting for other health conditions and high-sensitivity troponin (hs-cTn) levels.
Area of Science:
- Emergency Medicine
- Cardiology
- Geriatrics
Background:
- Chest pain is a common emergency department (ED) presentation.
- Age is a significant factor in patient outcomes.
- Understanding age-related differences in safety and healthcare utilization is crucial for effective ED protocols.
Purpose of the Study:
- To investigate the impact of age on safety and healthcare utilization in chest pain patients.
- To determine if age differences persist after adjusting for comorbidities and high-sensitivity troponin (hs-cTn).
Main Methods:
- A multisite observational study of 40,979 patients with chest pain across 25 EDs.
- Patients categorized into three age groups: young (18-45), middle-aged (46-64), and older (≥65).
- Outcomes assessed: 30-day death or myocardial infarction (MI) and 30-day hospitalization, analyzed using multivariable logistic regression.
Main Results:
- Older adults (≥65) had significantly higher rates of 30-day death or MI (7.3%) and hospitalization (56.3%) compared to younger groups.
- Middle-aged patients also showed increased risk compared to young patients.
- Adjusted analyses confirmed that older and middle-aged patients had significantly higher odds of death/MI and hospitalization.
Conclusions:
- Age is an independent predictor of adverse outcomes in chest pain patients presenting to the ED.
- Older adults experience greater safety risks and healthcare utilization post-chest pain presentation.
- These findings underscore the need for age-specific considerations in chest pain management protocols.
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