Age, clinical presentation, and outcome of acute coronary syndromes in the Euroheart acute coronary syndrome survey

Annika Rosengren*, Lars Wallentin, Maarten Simoons, Anselm K. Gitt, Solomon Behar, Alexander Battler, David Hasdai

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

266 Scopus citations

Abstract

Aims: Age is one of the most powerful determinants of prognosis in myocardial infarction, but there is comparatively little recent data across the whole spectrum of acute coronary syndromes (ACS). We examined the impact of increasing age on clinical presentation and hospital outcome in a large sample of patients with ACS. Methods and results: Patients (n = 10 253) from the Euroheart ACS survey in 103 hospitals in 25 countries were investigated. There was a significant inverse association between the age and the likelihood of presenting with ST-elevation. For each decade of life, the odds of presenting with ST-elevation decreased by 0.82 [95% confidence interval (CI) 0.79-0.84]; P < 0.0001. Elderly patients were considerably less often treated by cardiologists, less extensively investigated, and, when presenting with ST-elevation ACS, less likely to be treated with reperfusion. Compared with patients <55 years, the odds ratios of hospital mortality were 1.87 (1.21-2.88) at age 55-64, 3.70 (2.51-5.44) at age 65-74, 6.23 (4.25-9.14) at age 75-84, and 14.5 (9.47-22.1) among patients ≥85 years, with no major differences across different types of admission or discharge diagnoses. Conclusion: Elderly ACS patients were less likely to present with ST-elevation but had substantial in-hospital mortality, yet they were markedly less intensively treated and investigated.

Original languageEnglish
Pages (from-to)789-795
Number of pages7
JournalEuropean Heart Journal
Volume27
Issue number7
DOIs
StatePublished - Apr 2006
Externally publishedYes

Funding

FundersFunder number
Swedish Heart and Lung Foundation

    Keywords

    • Acute myocardial infarction
    • Aging
    • Coronary disease
    • Unstable angina

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