AIM  to analyze the clinical characteristics and the impact of treatment efficiency in elderly patients with acute myocardial infarction.

  METHODS  Retrospective analysis was made in 812 patients with acute myocardial infarction (AMI) who were admitted to Hubei Integrated Hospital of Traditional Chinese and Western Medicine from January 2015 to December 2020. The patients were divided into elderly group (75~89 years old, n = 344) and control group (< 75 years old, n = 468). Baseline data, symptoms and signs, laboratory examination, treatment and in-hospital total cause mortality rate of the two groups were collected and compared. Multivariate logistic regression was used to analyze the influencing factors of in-hospital death.

  RESULTS  Compared with the control group, the elderly group had less typical chest pain and more patients with history of hypertension, diabetes, coronary heart disease, NSTEMI and Killip > II, with significant difference between the two groups (P<0.01). The time from symptom to diagnosis in the elderly group was 26 ± 22 hours, which was significantly longer than that in the control group (15 ± 15 hours, P < 0.01). However, in the elderly group. there were significantly fewer patients who chose direct PCI and elective PCI and 86.9% of the patients who chose non-reperfusion therapy, which was significantly higher than the 60.9% in the control group. Multivariate logistic regression analysis showed that elderly age, atypical chest pain, Killip >II, ST-segment elevation myocardial infarction and non-reperfusion therapy were independent risk factors of in-hospital death (P<0.05).

  CONCLUSION  Elderly AMI patients have atypical symptoms and non-ST segment elevation and Killip > II are more common in them. More of them choose non-reperfusion therapy and not direct or selective PCI. Their in-hospital mortality is higher.