DIFFERENCES IN THE RISK FACTORS AND INPATIENTS OUTCOMES OF PATIENTS WITH ACUTE MYOCARDIAL INFARCTION BY AGE IN DURRES POPULATION

Eliverta Zera*, Ira Xhemollari and Sonela Xinxo

ABSTRACT

Background: Despite the greater risk of AMI among older patients and the increasing size of this population the relationship between age, clinical presentation and outcome of AMI in elderly patients is incompletely understood. The few studies have explored age-associated differences in AMI presentation and outcomes in elderly patients. Purpose: The objective of our study was to determine the frequency of risk factors and in hospital outcome in elderly patients me AMI. Methods: We enrolled in the study 499 patients consecutive with AMI admitted in cardiology department from October 2011 to October 2014.The baseline characteristics, traditional risk factors for CHD and in-hospital outcome were analyzed across some age-based strata (in years): 25-44, 45-54.55-64, 65 to 74, 75 to 84, and ≥85 years of age. Statistical analyses were performed with SPSS 16.0. P value of <0.05 was considered statistically significant. Results: Of 499 patients with AMI,19(3.8%) belonged age group 25-44 years old,62(12.4%) belonge age group 45-54 years old,153(30.7%) belonged age group 55-64 years old, 161(32.3%) belonged age group 65-74years old, 75(15%) belonged age group 75-84years old and 29(5.8%) belonged age group ≥85years old. Of them the percentage of female were higher in age group ≥85years old (37.9%) and the percentage of male were higher in age group 75-84 yrs (73.4%). The age group patients 65-74 yrs represented with ≥ 3 risk factors (31% vs 14.5% and 17.2%) and ≥4 risk factors (37.5% vs 19.2% and 24.1%). The age group patients 65-74 years more frequently had an anterior infarction (58.3% vs 50.6% and 27.7%) and the higher percentage of pulmonary edema (18% vs 1.3% and 13.7%) p 0.001.The age group ≥85 vj more frequently had an inferior infarction (68.9%) and congestive heart failure (33.3%) p 0.001 A small proportion of elderly patients underwent coronary angiography (16% vs 30.4%) and revascularization (58.3% vs 69.3%). In hospital mortality were higher in the age group ≥85 vj (17.2% vs 8%). p 0.002. Conclusions: The elderly patients with AMI were female, had a higher incidence of hypertension, smoking, obesity and hypercholesterolemia. Most of them had ≥ 2 risk factors. The elderly received less frequently a coronary angiography after episode of AMI. The prevalence of cardiac failure was higher in the elderly AMI patients. In hospital mortality were higher in this subset population. The risk of in hospital mortality were higher in this age group. Older age was associated with a greater proportion of patients with functional limitations, heart failure, prior coronary disease and renal insufficiency and a lower proportion of male and diabetic patients.

Keywords: Risk factors, elderly patients, outcomes, acute myocardial infarction.