European Heart Journal Advance Access published online on February 7, 2006
European Heart Journal, doi:10.1093/eurheartj/ehi774
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1 Department of Medicine, Sahlgrenska University Hospital/Ostra, SE-416 85 Göteborg, Sweden
* To whom correspondence should be addressed. Aims Age is one of the most powerful determinants of prognosis in myocardial infarction, but there is comparatively little recent data across the whole spectrum of acute coronary syndromes (ACS). We examined the impact of increasing age on clinical presentation and hospital outcome in a large sample of patients with ACS. Methods and results Patients (n = 10 253) from the Euroheart ACS survey in 103 hospitals in 25 countries were investigated. There was a significant inverse association between the age and the likelihood of presenting with ST-elevation. For each decade of life, the odds of presenting with ST-elevation decreased by 0.82 [95% confidence interval (CI) 0.79-0.84]; P < 0.0001. Elderly patients were considerably less often treated by cardiologists, less extensively investigated, and, when presenting with ST-elevation ACS, less likely to be treated with reperfusion. Compared with patients <55 years, the odds ratios of hospital mortality were 1.87 (1.21-2.88) at age 55-64, 3.70 (2.51-5.44) at age 65-74, 6.23 (4.25-9.14) at age 75-84, and 14.5 (9.47-22.1) among patients Conclusion Elderly ACS patients were less likely to present with ST-elevation but had substantial in-hospital mortality, yet they were markedly less intensively treated and investigated.
Received August 31, 2005
Revised January 9, 2005
Accepted January 19, 2006
Clinical research
Age, clinical presentation, and outcome of acute coronary syndromes in the Euroheart acute coronary syndrome survey
Annika Rosengren 1 *,
Lars Wallentin 2,
Maarten Simoons 3,
Anselm K Gitt 4,
Solomon Behar 5,
Alexander Battler 6,
and
David Hasdai 6
2 University Hospital, Uppsala, Sweden
3 Thoraxcenter, Rotterdam, The Netherlands
4 Klinikum der Stadt Ludwigshafen, Germany
5 Neufeld Cardiac Research Institute, Tel-Hashomer, Israel
6 Rabin Medical Center, Petah Tikva, Israel
Annika Rosengren, E-mail: annika.rosengren{at}hjl.gu.se
Abstract 
85 years, with no major differences across different types of admission or discharge diagnoses.
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