title: Age and its relationship to acute coronary syndromes in the Saudi Project for Assessment of Coronary Events (SPACE) registry: The SPACE age study.
abstract: OBJECTIVE
  To characterize risk profile of acute coronary syndrome (ACS) patients in different age groups and compare management provided to in-hospital outcome.
  
  
  METHODS
  Prospective multi-hospital registry.
  
  
  METHODS
  Seventeen secondary and tertiary care hospitals in Saudi Arabia.
  
  
  METHODS
  Five thousand and fifty-five patients with ACS. They were divided into four groups: ⩽40 years, 41-55 years, 56-70 years and ⩾70 years.
  
  
  METHODS
  prevalence, utilization and mortality.
  
  
  RESULTS
  Ninety-four percent of patients <40 years compared to 68% of patients >70 years were men. Diabetes was present in 70% of patients aged 56-70 years. Smoking was present in 66% of those <40 years compared to 7% of patients >70 years. Fifty-three percent of the patients >70 years and 25% of those <40 years had history of ischemic heart disease. Sixty percent of patients <40 years presented with ST elevation myocardial infarction (STEMI) while non-ST elevation myocardial infarction was the presentation in 49% of patients >70 years. Thirty-four percent of patients >70 years compared to 10% of patients <40 years presented >12 h from symptom onset with STEMI. Fifty-four percent of patients >70 compared to 64-71% of those <70 years had coronary angiography. Twenty-four percent of patients >70 compared to 34-40% of those <70 years had percutaneous coronary intervention. Reperfusion shortfall for STEMI was 16-18% in patients >56 years compared to 11% in patients <40 years. Mortality was 7% in patients >70 years compared to 1.6-3% in patients <70 years. For all comparisons (p < 0.001).
  
  
  CONCLUSIONS
  Young and old ACS patients have unique risk factors and present differently. Older patients have higher in-hospital mortality as they are treated less aggressively. There is an urgent need for a national prevention program as well as a systematic improvement in the care for patients with ACS including a system of care for STEMI patients. For older patients there is a need to identify medical as well as social factors that influence the therapeutic management plans.
authors: Saud AlBabtain Cardiac Center, Dammam.
authors: Shukri M
authors: SM
authors: Al-Saif
authors: Khalid F
authors: KF
authors: Alhabib
authors: Anhar
authors: A
authors: Ullah
authors: Ahmed
authors: A
authors: Hersi
authors: Husam
authors: H
authors: Alfaleh
authors: Khalid
authors: K
authors: Alnemer
authors: Amir
authors: A
authors: Tarabin
authors: Ahmed
authors: A
authors: Abuosa
authors: Tarek
authors: T
authors: Kashour
authors: Mushabab
authors: M
authors: Al-Murayeh
keywords: Acute coronary syndrome; Age; In-hospital outcome; Mortality
references: Heart. 2010 Nov;96(22):1798-802
references: 20736202
references: Circulation. 2007 May 15;115(19):2570-89
references: 17502591
references: Saudi Med J. 2007 Jan;28(1):77-84
references: 17206295
references: Lancet. 2008 Apr 26;371(9622):1435-42
references: 18440425
references: Circulation. 2007 Jul 10;116(2):217-30
references: 17538045
references: JAMA. 2000 Aug 16;284(7):835-42
references: 10938172
references: Circulation. 2007 May 15;115(19):2549-69
references: 17502590
references: J Am Coll Cardiol. 2001 Dec;38(7):2114-30
references: 11738323
references: Heart. 2009 Mar;95(5):362-9
references: 19218262
references: EuroIntervention. 2009 Nov;5(5):599-603
references: 20142181
references: EuroIntervention. 2009 Mar;4(5):555, 557
references: 19378673
references: J Saudi Heart Assoc. 2009 Jul;21(3):169-76
references: 23960568
references: Saudi Med J. 2008 Feb;29(2):251-5
references: 18246236
references: J Saudi Heart Assoc. 2011 Oct;23(4):233-9
references: 23960654
references: Angiology. 2012 Feb;63(2):119-26
references: 21602255
references: Eur Heart J. 2006 Apr;27(7):789-95
references: 16464911
references: EuroIntervention. 2009 Aug;5(3):299, 301-309
references: 19736153
references: Saudi Med J. 2004 Nov;25(11):1603-10
references: 15573186
references: Arch Intern Med. 2003 Oct 27;163(19):2345-53
references: 14581255