Risk factors of acute myocardial infarction in elderly and nonelderly patients: a comparative retrospective study done in a rural tertiary care centre of India
Keywords:Acute myocardial infarction, Elderly, Risk factors
Background: Cardiovascular diseases are the most common diagnosis in the elderly, and the first cause of death in men and women over 60 years. It is not clear if the risk factors of acute myocardial infarction (AMI) are different in elderly and non-elderly people. The aim of this study was to compare the prevalence of risk factors of acute myocardial infarction between elderly and non-elderly patients who had been admitted to hospital for the first attack of acute myocardial infarction (AMI).
Methods: A retrospective study was done in Narayan Medical College and Hospital, Jamuhar, Sasaram, Bihar from January 2017 to December 2017. Study population were all patients who were admitted due to AMI in medicine ward. Patients were selected as per World Health Organization guidelines. The patients were divided into two groups, non-elderly patients of <60 years and elderly patients of ≥60 years.
Results: Among different risk factors, diabetes and hypertension were more common in elderly than their non-elderly counterparts, and male gender, smoking and family history of ischemic heart disease was more common in non-elderly patients than elderly ones.
Conclusions: This study provide vital information on young AMI patients amongst the diverse population of north India and will help to guide the treating physicians and the health care system to adopt appropriate steps directed towards primary and secondary prevention of AMI in young patients of this region, especially smoking cessation, which is the commonest modifiable risk factor, in their most productive years of life.
Lopea AD, Mathers CD, Ezzati M. Global burden of disease and risk factors. In:Zipes DP, Libby P, Bonow RO, Mann DL, Braunwald E, editors. Braunwald’s Heart Disease: a textbook of cardiovascular medicine. 8th ed. Philadelphia: Saunders; 2008:1.
Singh RB, Niaz MA, Thakur AS, Janus ED, Moshiri M. Social class and coronary artery disease in a urban population of North India in the Indian Lifestyle and Heart Study. Int J Cardiol. 1998 Apr 1;64(2):195-203.
Gregoratos G. Clinical manifestations of acute myocardial infarction in older patients. The American J Geriatric Cardiol. 2001 Nov 1;10(6):345-7.
Lakatta EG. Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises: Part III: cellular and molecular clues to heart and arterial aging. Circulation. 2003 Jan 28;107(3):490-7.
Rich MW. Epidemiology, clinical features, and prognosis of acute myocardial infarction in the elderly. Am J Geriatr Cardiol. 2006 Jan-Feb;15(1):7-11; quiz 12.
Bonita R, Courten M, Dwyer T, Jamrozik K. Surveillance of risk factors for non communicable disease; WHO STEP wise Approach. Geneva: WHO, 2001.
Sharma R. Revision of Prasad's social classification and provision of an online tool for real-time updating. South Asian J Cancer. 2013 Jul;2(3):157.
Fong IW. Emerging relations between infectious diseases and coronary artery disease and atherosclerosis. Cmaj. 2000 Jul 11;163(1):49-56.
Barbash GI, White HD, Modan M, Diaz R, Hampton JR, Heikkila J, et al. Acute myocardial infarction in the young-the role of smoking. the investigators of the international tissue plasminogen activator/streptokinase mortality trial. European Heart J. 1995 Mar;16(3):313-6.
Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the Interheart study): case-control study. Lancet. 2004;364:937-52.
Aggarwal A, Aggarwal S, Goel A, Sharma V, Dwivedi S. A retrospective case-control study of modifiable risk factors and cutaneous markers in Indian patients with young coronary artery disease. JRSM Cardiovascular Dis. 2012 Jun;1(3):1-8.
Oliveira A, Barros H, Azevedo A, Bastos J, Lopes C. Impact of risk factors for non-fatal acute myocardial infarction. Eur J Epidemiol. 2009 Aug 1;24(8):425-32.
Chan MY, Woo KS, Wong HB, Chia BL, Sutandar A, Tan HC. Antecedent risk factors and their control in young patients with a first myocardial infarction. Singapore Med J. 2006 Jan;47(1):27-30.
Alshahrani H, McConkey R, Wilson J, Youssef M, Fitzsimons D. Female gender doubles pre-hospital delay times for patients experiencing ST segment elevation myocardial infarction in Saudi Arabia. Eur J Cardiovasc Nursing. 2014 Oct;13(5):399-407.
Hosseini SK, Soleimani A, Karimi AA, Sadeghian S, Darabian S, Abbasi SH, et al. Clinical features, management and in-hospital outcome of ST elevation myocardial infarction (STEMI) in young adults under 40 years of age. Monaldi Arch Chest Dis. 2009;72:71-6.
Zimmerman FH, Cameron A, Fisher LD, Grace NG. Myocardial infarction in young adults: angiographic characterization, risk factors and prognosis (Coronary Artery Surgery Study Registry). J Am Coll Cardiol. 1995 Sep 1;26(3):654-61.
McManus DD, Piacentine SM, Lessard D, Gore JM, Yarzebski J, Spencer FA, Goldberg RJ. Thirty-year (1975 to 2005) trends in the incidence rates, clinical features, treatment practices, and short-term outcomes of patients <55 years of age hospitalized with an initial acute myocardial infarction. Am J Cardiol. 2011 Aug 15;108(4):477-82.
Incalcaterra E, Caruso M, Lo Presti R, Caimi G. Myocardial infarction in young adults: risk factors, clinical characteristics and prognosis according to our experience. Therapeutic Clinic. 2013;164:e77-82.