Age-dependent differences in presentation, risk factor profile, and outcome of suspected acute coronary syndrome

R L Soiza, S J Leslie, K Harrild, N R Peden, A D Hargreaves

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

To compare the presenting complaint, risk factors, and outcome of suspected acute coronary syndrome (ACS) in those aged 65 and older with those of a younger cohort.

Prospective observational cohort study.

A typical Scottish district general hospital covering a population of 150,000.

Patients presenting with suspected ACS (N=869) over a 6-month period.

Main presenting complaint and major risk factors including electrocardiogram (ECG) changes. Primary outcome measures were percutaneous coronary intervention, recurrent myocardial infarction, and death at 3-month follow-up.

Four hundred seventy-seven (55%) were aged 65 and older. Older patients were less likely to present with chest pain and more likely to present with breathlessness or collapse. They had fewer major risk factors for heart disease. There was a higher proportion with ischemic ECG changes, elevated troponin, and major acute coronary events at follow-up. Older patients were less likely to be accepted for angiography even though they were more likely than the younger cohort to have significant coronary artery disease when angiography was performed (chi-square test, P <.01 for all above).

Older patients with suspected ACS were more likely to present atypically and have worse outcomes than their younger counterparts, despite having fewer major risk factors. The results highlight the importance of age as a predictor of adverse outcome and suggest that clinicians need to ensure equitable access to angiography for older patients.

Original languageEnglish
Pages (from-to)1961-1965
Number of pages5
JournalJournal of the American Geriatrics Society
Volume53
DOIs
Publication statusPublished - 2005

Keywords

  • acute coronary syndrome
  • elderly
  • presentation
  • risk factors
  • outcome
  • ST-SEGMENT ELEVATION
  • ACUTE ISCHEMIC SYNDROMES
  • UK PRAIS-UK
  • ELDERLY-PATIENTS
  • UNSTABLE ANGINA
  • PROSPECTIVE REGISTRY
  • INVASIVE MANAGEMENT
  • GLOBAL REGISTRY
  • PREDICTORS
  • MORTALITY

Cite this

Age-dependent differences in presentation, risk factor profile, and outcome of suspected acute coronary syndrome. / Soiza, R L ; Leslie, S J ; Harrild, K ; Peden, N R ; Hargreaves, A D .

In: Journal of the American Geriatrics Society, Vol. 53, 2005, p. 1961-1965.

Research output: Contribution to journalArticle

@article{643395fe123649c88bf513b6566bb5fb,
title = "Age-dependent differences in presentation, risk factor profile, and outcome of suspected acute coronary syndrome",
abstract = "To compare the presenting complaint, risk factors, and outcome of suspected acute coronary syndrome (ACS) in those aged 65 and older with those of a younger cohort.Prospective observational cohort study.A typical Scottish district general hospital covering a population of 150,000.Patients presenting with suspected ACS (N=869) over a 6-month period.Main presenting complaint and major risk factors including electrocardiogram (ECG) changes. Primary outcome measures were percutaneous coronary intervention, recurrent myocardial infarction, and death at 3-month follow-up.Four hundred seventy-seven (55{\%}) were aged 65 and older. Older patients were less likely to present with chest pain and more likely to present with breathlessness or collapse. They had fewer major risk factors for heart disease. There was a higher proportion with ischemic ECG changes, elevated troponin, and major acute coronary events at follow-up. Older patients were less likely to be accepted for angiography even though they were more likely than the younger cohort to have significant coronary artery disease when angiography was performed (chi-square test, P <.01 for all above).Older patients with suspected ACS were more likely to present atypically and have worse outcomes than their younger counterparts, despite having fewer major risk factors. The results highlight the importance of age as a predictor of adverse outcome and suggest that clinicians need to ensure equitable access to angiography for older patients.",
keywords = "acute coronary syndrome, elderly, presentation, risk factors, outcome, ST-SEGMENT ELEVATION, ACUTE ISCHEMIC SYNDROMES, UK PRAIS-UK, ELDERLY-PATIENTS, UNSTABLE ANGINA, PROSPECTIVE REGISTRY, INVASIVE MANAGEMENT, GLOBAL REGISTRY, PREDICTORS, MORTALITY",
author = "Soiza, {R L} and Leslie, {S J} and K Harrild and Peden, {N R} and Hargreaves, {A D}",
year = "2005",
doi = "10.1111/j.1532.5415.2005.53573.x",
language = "English",
volume = "53",
pages = "1961--1965",
journal = "Journal of the American Geriatrics Society",
issn = "0002-8614",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - Age-dependent differences in presentation, risk factor profile, and outcome of suspected acute coronary syndrome

AU - Soiza, R L

AU - Leslie, S J

AU - Harrild, K

AU - Peden, N R

AU - Hargreaves, A D

PY - 2005

Y1 - 2005

N2 - To compare the presenting complaint, risk factors, and outcome of suspected acute coronary syndrome (ACS) in those aged 65 and older with those of a younger cohort.Prospective observational cohort study.A typical Scottish district general hospital covering a population of 150,000.Patients presenting with suspected ACS (N=869) over a 6-month period.Main presenting complaint and major risk factors including electrocardiogram (ECG) changes. Primary outcome measures were percutaneous coronary intervention, recurrent myocardial infarction, and death at 3-month follow-up.Four hundred seventy-seven (55%) were aged 65 and older. Older patients were less likely to present with chest pain and more likely to present with breathlessness or collapse. They had fewer major risk factors for heart disease. There was a higher proportion with ischemic ECG changes, elevated troponin, and major acute coronary events at follow-up. Older patients were less likely to be accepted for angiography even though they were more likely than the younger cohort to have significant coronary artery disease when angiography was performed (chi-square test, P <.01 for all above).Older patients with suspected ACS were more likely to present atypically and have worse outcomes than their younger counterparts, despite having fewer major risk factors. The results highlight the importance of age as a predictor of adverse outcome and suggest that clinicians need to ensure equitable access to angiography for older patients.

AB - To compare the presenting complaint, risk factors, and outcome of suspected acute coronary syndrome (ACS) in those aged 65 and older with those of a younger cohort.Prospective observational cohort study.A typical Scottish district general hospital covering a population of 150,000.Patients presenting with suspected ACS (N=869) over a 6-month period.Main presenting complaint and major risk factors including electrocardiogram (ECG) changes. Primary outcome measures were percutaneous coronary intervention, recurrent myocardial infarction, and death at 3-month follow-up.Four hundred seventy-seven (55%) were aged 65 and older. Older patients were less likely to present with chest pain and more likely to present with breathlessness or collapse. They had fewer major risk factors for heart disease. There was a higher proportion with ischemic ECG changes, elevated troponin, and major acute coronary events at follow-up. Older patients were less likely to be accepted for angiography even though they were more likely than the younger cohort to have significant coronary artery disease when angiography was performed (chi-square test, P <.01 for all above).Older patients with suspected ACS were more likely to present atypically and have worse outcomes than their younger counterparts, despite having fewer major risk factors. The results highlight the importance of age as a predictor of adverse outcome and suggest that clinicians need to ensure equitable access to angiography for older patients.

KW - acute coronary syndrome

KW - elderly

KW - presentation

KW - risk factors

KW - outcome

KW - ST-SEGMENT ELEVATION

KW - ACUTE ISCHEMIC SYNDROMES

KW - UK PRAIS-UK

KW - ELDERLY-PATIENTS

KW - UNSTABLE ANGINA

KW - PROSPECTIVE REGISTRY

KW - INVASIVE MANAGEMENT

KW - GLOBAL REGISTRY

KW - PREDICTORS

KW - MORTALITY

U2 - 10.1111/j.1532.5415.2005.53573.x

DO - 10.1111/j.1532.5415.2005.53573.x

M3 - Article

VL - 53

SP - 1961

EP - 1965

JO - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

SN - 0002-8614

ER -