Author/Editor		Svenšek, Franc; Sinkovič, Andreja; Pehnec, Zlatko
Title		Acute coronary syndromes in the elderly treated at the Maribor teaching hospital in 2002 and 2003
Translated title		Akutni koronarni sindromi pri starejših v Učni bolnišnici Maribor v letih 2002 in 2003
Type		članek
Source		Slov Kardiol
Vol. and No.		Letnik 2, št. 2
Publication year		2005
Volume		str. 118-21
Language		eng
Abstract		Background. Despite the higher incidence and risk of unfavorable outcome of acute coronary syndromes (ACS) in the elderly compared to younger patients, little evidence exists of their optimal treatment. Our aim was to make a retrospective comparison of their clinical characteristics upon admission, in-hospital treatments and mortality rates between older (> 65 years) and younger (> 65 years) patients with ACS who were admitted to our unit in 2002 and 2003. Patients and methods. Out of 633 patients with ACS in 2002 and 2003, 367 aged > 65 years (57.9%) were also treated with i.v. thrombolysis or primary percutaneous coronary intervention (PCI) in case of ACS with ST-segment elevation (STEMI). Results. In patients aged > 65 years compared to younger patients, aged < 65 years, with ACS, there was significantly less STEMI (46.6% vs 64.7%, p < 0.05), less primary PCI (18.5% vs. 28.9%, p < 0.05) and i.v. thrombolysis (6.8% vs 17.7%, p < 0.05) and less frequent chest pain lasting up to three hours (24.5% vs. 38.7% p<0.05), but significantly more frequent non-Q myocardial infarction (28.3% vs. 17.3%, p<0.05), heart failure of Killip classes II, III and IV upon admission (28.1% vs. 15%; 12.3% vs. 3.8%; 13.9% vs. 4.9%; p<0.05), medical treatment (54.5% vs. 27.1%, p<0.05) and also significantly increased in-hospital mortality (21.3% vs. 4.9%, p<0.05). Conclusions. 57.9% of patients with ACS were aged >65 years and had significantly less frequent STEMI, with significantly more frequent non-Q myocardial infarction and heart failure upon admission, as well as significantly increased in-hospital mortality compared to younger patients.
Summary		Izhodišča. Akutni koronarni sindrom starostnike prizadene pogosteje kot mlajše bolnike in je praviloma povezan manj ugodnim razpletom, kljub temu pa nimamo na voljo dokazov, ki bi nakazali njihovo optimalno oskrbo. Z našo raziskavo smo želeli retrospektivno primerjati klinične značilnosti, bolnišnično oskrbo in umrljivost pri starejših (>=65 let) in mlajših (<65 let) bolnikih, ki so bili med letoma 2002 in 2003 v našo bolnišnico sprejeti zaradi akutnega koronarnega sindroma. Bolniki in metode. V opazovanem obdobju smo 633 bolnikov (367/57,9% starejših od 65 veznice ST (STEMI). Izsledki. Pri starejših bolnikih smo v primerjavi z mlajšimi zabeležili manj STEMI (46,6% proti 64,7%, p<0,05); manj starostnikov smo oskrbeli s perkutanim posegom (18,5% proti 28,9%, p<0,05) ali trombolizo (6,8% proti 17,7%, p<0.05), pri njih je tudi prsna bolečina redkeje vztrajala manj kot tri ure (24,5% vs. 38.7%, p<0.05), pač pa smo pri njih pogosteje zabeležili srčni infarkt brez zobca Q (28.3% vs. 17.3%, p<0.05), srčno popuščanje v Killipovih razredih II, III ali IV (28.1% vs. 15%; 12.3% vs. 3.8%; 13.9% vs. 4.9%; p<0.05), pogosteje smo jih zdravili z zdravili (54.5% vs. 27.1%, p<0.05), pri njih pa je bila večja umrljivost (21.3% vs. 4.9%, p<0.05). Zaključki. 57.9% bolnikov z akutnim koronarnim sindromom je bilo starih 65 let ali več, redkeje so utrpeli STEMI, pogosteje pa infarkt brez zobca Q in srčno popuščanje, v primerjavi z mlajšimi pa je bila pri njih večja umrljivost.
Descriptors		MYOCARDIAL INFARCTION ANGINA, UNSTABLE HOSPITAL MORTALITY ELECTROCARDIOGRAPHY NITROGLYCERIN AGED ASPIRIN HEPARIN, LOW-MOLECULAR-WEIGHT