Acute Coronary Syndrome in the Elderly: Assessment of Risk Factors, Management Strategies and Complications

Background: ACS is a leading cause of mortality worldwide, but it is unknown whether the advanced age of patients constitutes a prognostic factor. Objective: The present study compared the burden of risk factors and the prognosis of ACS in older and younger patients in order to improve their management. Methods. A retrospective analysis of a series of ACS patients admitted from January to December 2022 to intensive care unit of the cardiology department at the South Francilian Hospital Center. Results: The files of 551 patients including 60 elderly subjects (10.9%) were analyzed. Average age was 81.7 ± 6.1 years for the elderly, 54.5 ± 11.9 years for the younger patients. Men predominated in both age categories (p = 0.014) and were older than women (59.2 ± 14.3 vs 53.1 ± 13.2 years; p = 0.014). Obesity (p = 0.007), smoking (p = 0.002) and dyslipidemia (p = 0.022) were the cardiovascular risk factors found more in elderly patients, hypertension (p < 0.001) and diabetes (p < 0.001) in the youngest. NSTEMI (66.3%) predominated in both the elderly (55.0%) and the younger (60.8%) subjects. Treatment consisted of immediate angioplasty in 66.1%, including 61.7% elderly subjects and 66.6% younger subjects (p = 0.224). Death was significantly associated with the severity of coronary lesions (p < 0.001) and chronic renal failure (p = 0.006), with no significant influence of age. Conclusion: The proportion of elderly subjects with ACS is not negligible. Comorbidities increase the prognosis, without age per se being associated with death.

Keywords ACS, Elderly, Angioplasty, Prognosis, Death