Risk factors, clinical features and outcomes of acute myocardial infarction in elderly and young patients – A comparative study

Sura Kishore Mishra, Abinash Panda, Indira Palo, Mahesh Khushwaha

Abstract


Introduction: Age is a strong and independent risk factor for the development of coronary atherosclerosis. AMI is a disease of older population and is uncommon in young, though it occurs at younger age in India compared to Western population. This emphasizes the growing importance of examining the risk factors and outcomes in the elderly and young in discrete populations. With age, multiple co-morbidities develop that intertwine and fundamentally alter the management of CVD. The primary objective of the present study is to compare the risk factors, clinical features, outcomes of AMI in elderly (age 3 60 years) and younger patients with AMI (age < 60 years)
Materials and Methods: This hospital based observational study was carried out on 200 study participants of either gender, with a diagnosis of AMI recruited on the basis of simple random sampling with replacement using a random number table. For the purpose of comparison 100 cases of AMI below the
age of < 60 years (young) and 100 cases aged 60 years (elderly) were included in either groups (I and II) respectively. The study parameters with respect to the risk factors, clinical features and outcomes of acute myocardial infarction were studied on the 1st , 7th and 30th day of follow up.
Results: Mean age of patients in the Group I (young, age <60 years) was 51.9 3.8yrs where as that of Group II (elderly, age 60 years) was 69.5 5.3 yrs. Males were affected more than females in either groups. Hypertension was most common risk factor seen in elderly (46%) whereas smoking was the predominant risks factor the young (54%). Elderly patients reported to the hospital late during the illness as compared to those in the younger. NSTEMI, LBBB, Killip’s class III & IV heart failure were more frequently seen in elderly. LMCA was more involved in elderly patient. Thrombolysis was done in less in elderly compared to young, so also -blockers, ACEI were used less in the elderly. The elderly had a higher mortality on 1st; 7th and 30th day of follow-up.
Conclusion: Manifestations of AMI in elderly are more subtle with more atypical presentations and have higher rate of complications and mortality. A high index of suspicion is important in elderly patients to achieve a timely management.

Keywords: Acute Myocardial Infarction, Risk factors, Outcome, Age.


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