Published on:
    Journal of Cardiovascular Disease Research, 2013; 4(2):134-139
    Original Article | doi:10.1016/j.jcdr.2012.08.005

    Age and clinical outcomes in patients presenting with acute coronary syndromesq

    Authors:

    Emad Ahmed a, Khalid F. AlHabib b, Ayman El-Menyar a,c,d, Nidal Asaad a, Kadhim Sulaiman e, Ahmad Hersi b, Wael Almahmeed f, Alawi A. Alsheikh-Ali f, Haitham Amin g, Ahmed Al-Motarreb h, Shukri Al Saif i, Rajvir Singh j, Jawad Al-Lawati k, Jassim Al Suwaidi a,*

    a Department of Cardiology, Heart Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar

    b King Fahad Cardiac Centre, College of Medicine, King Saud University, 11472, Riyadh, Saudi Arabia

    c Department of Clinical Medicine, Weill Cornell Medical School, 24144, Doha, Qatar

    d Department of Medicine, Cardiology Unit, Ahmed Maher Teaching Hospital, Cairo, Egypt

    e Department of Cardiology, Royal Hospital, Muscat, Oman

    f Department of Cardiology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates

    g Department of Cardiology, Mohammed Bin Khalifa Cardiac Center, Manama, Bahrain

    h Department of Cardiology, Faculty of Medicine, Sana’a University, Sana’a, Yemen

    iSaud Al-Babtain Cardiac Centre, 11850, Dammam, Saudi Arabia

    j Medical Research Center, Hamad Medical Corporation, PO Box 3050, Doha, Qatar

    k Department of Non-communicable Diseases, Ministry of Health, Muscat, Oman

    Abstract:

    Context: Elderly patients have more cardiovascular risk factors and a greater burden of ischemic disease than younger patients. Aims: To examine the impact of age on clinical presentation and outcomes in patients presenting with acute coronary syndrome (ACS). Methods and material: Collected data from the 2nd Gulf Registry of Acute Coronary Events (Gulf RACE-2), which is a prospective multicenter study from six adjacent Arab Middle Eastern Gulf countries. Patients were divided into 3 groups according to their age: 50 years, 51-70 years and >70 years and their clinical characteristics and outcomes were analyzed. Mortality was assessed at one and 12 months. Statistical analysis used: One-way ANOVA test for continuous variables, Pearson chi-square (X2) test for categorical variables and multivariate logistic regression analysis for predictors were performed. Results: Among 7930 consecutive ACS patients; 2755 (35%) were 50 years, 4110 (52%) were 51-70 years and 1065 (13%) >70 years old. The proportion of women increased with increasing age (13% among patients 50 years to 31% among patients > 70 years). The risk factor pattern varied with age; younger patients were more often obese, smokers and had a positive family history of CAD, whereas older patients more likely to have diabetes mellitus, hypertension, and dyslipidemia. Advancing age was associated with under-treatment evidence-based therapies. Multivariate logistic regression analysis after adjusting for relevant covariates showed that old age was independent predictors for re-ischemia (OR 1.29; 95% CI 1.03-1.60), heart failure (OR 2.8; 95% CI 2.17-3.52) and major bleeding (OR 4.02; 95% CI 1.37 -11.77) and in-hospital mortality (age 51e70: OR 2.67; 95% CI 1.86-3.85, and age >70: OR 4.71; 95% CI 3.11-7.14). Conclusion: Despite being higher risk group, elderly are less likely to receive evidence-based therapies and had worse outcomes. Guidelines adherence is highly recommended in elderly.

    Key words: Acute coronary syndrome, Age, Elderly.