V C Woon1, K H Lim. 1. Division of Geriatric Medicine, Changi General Hospital, 2 Simei Street 3, Singapore 529889. Voon_Ching_Woon@cgh.com.sg
Abstract
OBJECTIVES: The aim of the study was to determine the differences in presentation, complications, management and outcome of elderly patients with acute myocardial infarction (AMI) compared to young patients. MATERIALS AND METHODS: All case-notes with a discharge or death diagnosis ofAMI between January and July 1999 at a restructured hospital in Singapore were reviewed retropectively. Patients were categorised into those younger than 65 years (young) and those 65 years or older (elderly). Data on the demographic and clinical profile of patients were collected. RESULTS: There were 112 young and 101 elderly AMI patients. Chest pain was the most common presentation in both age groups, but more likely in the young than the elderly (89.3% vs 66.3%; p < 0.001). Atypical presentations were more likely in the elderly, with shortness of breath as the most common presentation (20.8% vs 5.4%; p < 0.001). The elderly were more likely to have complications of cardiac failure (65.3% vs 25%; p < 0.001) and cardiogenic shock (8.9% vs 0.9%; p = 0.006). The elderly were less likely to receive thrombolytic therapy (35.8% vs 64.8%; p < 0.001) as they were more likely to have contraindications (34.5% vs 6.8%; p = 0.002). The elderly were also less likely to receive beta-blockers (21.8% vs 60.7%; p < 0.001). In-hospital mortality was higher in the elderly (20.8% vs 2.7%; p < 0.001). Cardiogenic shock complicating AMI was associated with high in-hospital mortality. CONCLUSION: In AMI patients, chest pain was the most common presentation in both age groups, though less frequently in the elderly. Atypical presentations were more likely in the elderly, with shortness of breath as the most common atypical presentation. In elderly AMI patients, prevalence of cardiac failure was higher, use of beta-blockers was lower and in-hospital mortality was higher than young patients.
OBJECTIVES: The aim of the study was to determine the differences in presentation, complications, management and outcome of elderly patients with acute myocardial infarction (AMI) compared to young patients. MATERIALS AND METHODS: All case-notes with a discharge or death diagnosis ofAMI between January and July 1999 at a restructured hospital in Singapore were reviewed retropectively. Patients were categorised into those younger than 65 years (young) and those 65 years or older (elderly). Data on the demographic and clinical profile of patients were collected. RESULTS: There were 112 young and 101 elderly AMI patients. Chest pain was the most common presentation in both age groups, but more likely in the young than the elderly (89.3% vs 66.3%; p < 0.001). Atypical presentations were more likely in the elderly, with shortness of breath as the most common presentation (20.8% vs 5.4%; p < 0.001). The elderly were more likely to have complications of cardiac failure (65.3% vs 25%; p < 0.001) and cardiogenic shock (8.9% vs 0.9%; p = 0.006). The elderly were less likely to receive thrombolytic therapy (35.8% vs 64.8%; p < 0.001) as they were more likely to have contraindications (34.5% vs 6.8%; p = 0.002). The elderly were also less likely to receive beta-blockers (21.8% vs 60.7%; p < 0.001). In-hospital mortality was higher in the elderly (20.8% vs 2.7%; p < 0.001). Cardiogenic shock complicating AMI was associated with high in-hospital mortality. CONCLUSION: In AMI patients, chest pain was the most common presentation in both age groups, though less frequently in the elderly. Atypical presentations were more likely in the elderly, with shortness of breath as the most common atypical presentation. In elderly AMI patients, prevalence of cardiac failure was higher, use of beta-blockers was lower and in-hospital mortality was higher than young patients.
Authors: Gilson Soares Feitosa-Filho; José Maria Peixoto; José Elias Soares Pinheiro; Abrahão Afiune Neto; Afonso Luiz Tavares de Albuquerque; Álvaro César Cattani; Amit Nussbacher; Ana Amelia Camarano; Angela Hermínia Sichinels; Antonio Carlos Sobral Sousa; Aristóteles Comte de Alencar Filho; Claudia F Gravina; Dario Celestino Sobral Filho; Eduardo Pitthan; Elisa Franco de Assis Costa; Elizabeth da Rosa Duarte; Elizabete Viana de Freitas; Emilio Hideyuki Moriguchi; Evandro Tinoco Mesquita; Fábio Fernandes; Gilson Soares Feitosa; Humberto Pierre; Ilnei Pereira Filho; Izo Helber; Jairo Lins Borges; Jéssica Myrian de Amorim Garcia; José Antonio Gordillo de Souza; José Carlos da Costa Zanon; Josmar de Castro Alves; Kalil Lays Mohallem; Laura Mariana de Siqueira Mendonça Chaves; Lídia Ana Zytynski Moura; Márcia Cristina Amélia da Silva; Maria Alice de Vilhena Toledo; Maria Elisa Lucena Sales de Melo Assunção; Mauricio Wajngarten; Mauro José Oliveira Gonçalves; Neuza Helena Moreira Lopes; Nezilour Lobato Rodrigues; Paulo Roberto Pereira Toscano; Pedro Rousseff; Ricardo Antonio Rosado Maia; Roberto Alexandre Franken; Roberto Dischinger Miranda; Roberto Gamarski; Ronaldo Fernandes Rosa; Silvio Carlos de Moraes Santos; Siulmara Cristina Galera; Stela Maris da Silva Grespan; Teresa Cristina Rogerio da Silva; William Antonio de Magalhães Esteves Journal: Arq Bras Cardiol Date: 2019-06-06 Impact factor: 2.000