Comparison of epidemiology, treatments and outcomes of ST segment elevation myocardial infarction between young and elderly patients

Abstract

Elderly STEMI patients were less likely to receive PCI and had longer door to balloon times. Survival benefit of PCI decreased after the age of 65 years, with the decline most evident from age 85 years onwards. The risks of PCI need to be weighed carefully against its benefits, especially in very elderly patients.

Characteristics and outcomes of young patients with ST segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: retrospective analysis in a multiethnic Asian population

“…27 Diabetes was also shown in our study to have a strong trend towards all-cause mortality in both the young and older patients with STEMI and similar studies showed that young patients with STEMI with diabetes had higher mortality during follow-up. [17][18][19] Our study is also the first to show the prevalence of multivessel disease in young patients with STEMI within our population. [19][20][21] Almost a third (31%) of our young patients with STEMI had multivessel disease whereas in other similar studies done in predominantly Caucasian populations, the prevalence of multivessel disease in young patients with STEMI was around 22%.…”

“…[17][18][19] Our study is also the first to show the prevalence of multivessel disease in young patients with STEMI within our population. [19][20][21] Almost a third (31%) of our young patients with STEMI had multivessel disease whereas in other similar studies done in predominantly Caucasian populations, the prevalence of multivessel disease in young patients with STEMI was around 22%. 17 18 Young patients with STEMI who had multivessel disease also had worse mortality outcomes compared with those with single vessel disease.…”

“…The majority of previous studies of young patients with STEMI included mixed MI presentations, or were studies done in predominantly Caucasian populations. 7–15 17 18 There were few prior studies on our local population with STEMI and these were focused on differences in more elderly patients (age ≥65), 19 or did not study characteristics and outcomes in young compared with older patients with STEMI. 20 21…”

“…The majority of previous studies of young patients with STEMI included mixed MI presentations, or were studies done in predominantly Caucasian populations. 7-15 17 18 There were few prior studies on our local population with STEMI and these were focused on differences in more elderly patients (age ≥65), 19 or did not study characteristics and outcomes in young compared with older patients with STEMI. 20 21 Our study showed the high prevalence (61.1%) of current smokers among the young patients with STEMI and this is similar to previous studies on young patients with MI with prevalence of smoking ranging from 47% to 83%.…”

Impact of STEMI Diagnosis and Catheterization Laboratory Activation Systems on Sex- and Age-Based Differences in Treatment Delay

“…Despite significant advances in treatment, both women and older patients diagnosed with ST-elevation myocardial infarction (STEMI) continue to experience suboptimal treatment delays (TD) [1][2][3] and higher rates of adverse outcomes. [3][4][5] This persistent gap is often attributed to atypical symptoms, 6,7 longer delays between symptom onset and diagnosis, 3,8,9 and less frequent use of invasive testing than in younger patients 5 and men. 10 Longer door-to-device times and first medical contact-to-device times (FMC-to-device) are associated with increased mortality following STEMI, 2,11 and these delays have been reported to be significantly longer for women and older patients.…”