Differences in presentation, treatment, and prognosis in elderly patients with non‑ST‑segment elevation myocardial infarction

INTRODUCTION Advanced age is a significant risk factor for acute coronary syndrome (ACS). Because women live longer than men, they constitute the majority of elderly patients with ACS.
OBJECTIVES The aim of the study was to assess differences in clinical presentation, treatment, and prognosis in elderly women with non‑ST‑segment elevation myocardial infarction (NSTEMI).
PATIENTS AND METHODS A total of 1219 consecutive patients with NSTEMI (women, 43%) hospitalized during 1 year in a district of 1,300,000 inhabitants were analyzed. Data concerning in‑hospital course were obtained from the Polish Registry of Acute Coronary Syndromes (PL‑ACS), data on rehospitalization from the local branch of the National Health Fund, and data on mortality from the local register office.
RESULTS There were 387 patients aged under 65 years (women, 27%) and 832 aged over 65 years (women, 50.1%). In both groups, women had more risk factors than men. Coronary angiography and percutaneous transluminal coronary angioplasty were performed less frequently in the age group over 65 years, both in men and women, compared with the younger age group (23.8% vs. 41.9%, P <0.001 and 11.8% vs. 25.6%, P <0.01, respectively). Treatment outcomes were comparable between men and women in both age groups.
CONCLUSIONS In elderly patients with NSTEMI, the percentage of women is higher than that of men compared with the younger age group. Despite the fact that invasive approach was less frequently used
in women, long‑term prognosis was similar in both sexes.