ACUTE CORONARY SYNDROME IN ELDERLY PATIENTS

We conducted a retrospective analysis of 583 cases of patients aged 75 years and older hospitalised in the Intensive Care Unit No. 2, Regional Vascular Center No. 1, Republic’s Hospital No. 2 - Emergency Medical Center, and diagnosed with ACS (Q-positive MI, Q-negative myocardial infarction, unstable angina pectoris). The results of the study showed that the proportion of people of senile age made 16 % of the number of all hospitalised patients in 2015-2017. No ethnic differences were obtained. ACS in women aged 75 years and older was 2.5 times more common than in men of the same age; however, at the same time, in the age group of patients under 75 years old, ACS was 1.5 times more likely to be found in men than in women, which is consistent with literature data. According to nosological forms, unstable angina and Q-positive MI were more common. Selective coronary angiography (SCAG) was performed in 41.4 % of patients due to the presence of severe comorbidity, as well as the refusal of patients to perform SCAG. 35 % of the analyzed patients had three coronary arteries affected, which required surgical treatment of coronary heart disease (aortocoronary, mammaro-coronary artery bypass grafting). The coronary artery stenting was performed in 60 % of the patients undergoing SCAG. High mortality was revealed in patients with Q-negative myocardial infarction (27.8 %), which indicates the need for early revascularization of coronary vessels. It should be noted that 33 % of senile patients sought medical treatment within 24 hours after the debut of the disease. Late access to medical care in this group of patients is a factor that reduces the chances of performing myocardial reperfusion.

acute coronary syndrome, coronary heart disease, myocardial infarction, unstable angina, coronary artery, acute heart failure, endovascular intervention, coronary angiography, percutaneous coronary intervention, stenting, trombolytic therapy

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