Abstract

As elderly remain a vastly understudied population with significant differences from the younger patients, we aimed to study the profile of acute coronary syndrome (ACS) exclusively in elderly along with in hospital outcomes. Methods: This prospective observational study enrolled 200 elderly ACS patients and studied their demographic, clinical and angiographic profile. After any coronary intervention as indicated, in hospital occurrence of death due to any cause and major adverse cardiovascular events were noted. Results: Average age of study population was 75 years with majority being male (69%). Dyslipidemia, family history of CAD, diabetes, hypertension and smoking constituted 9%, 9%, 22%, 30% and 61% of patients respectively. STEMI was the commonest presentation (53%). LAD was the most common artery involved (79%) and ostio-proximal left circumflex (LCx) involvement (32%) was common (p-value ˂ 0.05). Cardiac cause accounted for 80% of total mortality. LVEF <35%, presence of mitral regurgitation (MR), involvement of left main (LM), LCx or right coronary artery (RCA) and triplevessel disease (TVD) showed a significant association with mortality (p-value ˂ 0.05). Conclusions: Elderly patients with ACS commonly have a multivessel disease which correlates with elevated. The important predictors of short-term mortality include higher serum troponin levels, LVEF < 35%, significant MR, involvement of LM and presence of TVD.

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