[Acute coronary syndromes in patients over 80 years old].
Atherosclerosis is regarded as a chronic disease. Because of its progressive character the most advanced cases of atherosclerosis are expected to be found in elderly population.


OBJECTIVE
We decided to take a closer look at a population of patients above 80 years of age who were admitted to our Center because of ACS.


METHODS
Included in our study were 50 consecutive cases of patients admitted with less than 12-hour history of symptoms of ACS . Their age ranged from 80 to 93 years with a mean of 82 years. All patients were subjected to: complete history and physical examination, 12-lead ECG, 2-D Echocardiography and laboratory studies including CPK, CK-MB, lipid profile, glucose and creatinine level. In the researched group 44 patients underwent coronary angiography and 32 of them required PTCA. Six patients in the group managed with invasive studies subsequently expired. Patients were analyzed in respect to: infarct site, coronary vessel lesion localization, cardiac enzymes levels, LV ejection fraction and renal insufficiency. We also compared groups with ST segment elevations, NSTEMI and unstable angina. Separately analysis of a group of deceased patients was conducted.


RESULTS
Six of our patients expired. Their mean age was higher than of the whole group. They also presented with significantly higher levels of cardiac enzymes. In majority of cases right coronary artery occlusion was found to be the culprit lesion.


CONCLUSIONS
Therefore, in complicated cases of elderly with multi-vessel atherosclerotic changes not qualifying for surgical revascularisation attempts to improve blood supply in the territory of the RCA might be considered.
Dabek
Józefa
J
Slska Akademia Medyczna w Katowicach, Katedra i Klinika Kardiologii.
Jakubowski
Daniel
D
Gasior
Zbigniew
Z
D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000175:diagnosis* / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary; D001786:Blood Glucose; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications*; D003402:Creatine Kinase / Q000097:blood; D052279:Creatine Kinase, MB Form / Q000097:blood; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000628:therapy*; D016896:Treatment Outcome
D001786:Blood Glucose; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form