The clinical and coronary angiographic characteristics in patients older than 75 years with acute ST segment elevation myocardial infarction

doi:10.3969/j.issn.1672-5301.2017.10.007

Abstract：Objective To investigate the clinical and coronary angiographic (CAG) characteristics in patients older than 75 years with acute ST segment elevation myocardial infarction (STEMI).Methods The clinical characteristics and CAG findings were analyzed between elderly patients (older than 75 years,n=97) and non-elderly patients (below 75 years old,n=92) with STEMI.Results Compared with the non-elderly patients,the rates of hypertension,diabetes,hyperlipidemia,old myocardial infarction,stroke history and insufficiency of pulmonary function were higher in the elderly cases.A downward trend of smoking and positive family history in the elderly patients was observed,but there was no statistically significant difference (P＞0.05).Moreover,the rates of percutaneous coronary intervention(PCI) history and chronic renal insufficiency (lower estimated glomerular filtration rate,eGFR) were higher in the elderly patients compared with the control group[24.7％ vs 10.9％,(52.1± 4.2)ml·min-1· 1.73 m-2 vs (63.7±2.3)ml· min-1 · 1.73 m-2,both P＜0.05,respectively].The elderly patients represented with more atypical chest pain,accounted for about 34.1％ and mainly characterized by dyspnea (16.5％ vs 6.5％,P＜0.05).Other atypical symptoms such as gastrointestinal symptoms and syncope were similar (13.4％ vs 5.4％ and 5.2％ vs 5.4％,both P＞0.05,respectively).Less elderly patients represented with Killip Ⅰ cardiac function (51.5％ vs 71.7％,P＜0.01),while the rate of Killip Ⅱ-Ⅲ cardiac function was higher (38.2％ vs 22.9％,P＜0.05).There were more patients with multi-vessel lesions,collateral vessel and complex lesions in the elderly group (81.4％ vs 65.2％,P＜0.05,82.5％ vs 68.5％,P＜0.01,61.1％ vs 47.8％,P＜0.05).Conclusion Elderly patients with acute myocardial infarction more frequently character by PCI history,renal dysfunction,atypical chest pain and more CAG characteristics such as multi-vessel lesions,collateral vessel and complex lesions.