[Coronary risk factors and mode of ischemic heart disease treatment in patients over 65 years of age].Przegl Lek. 2003; 60(7):451-5.PL
The aim of the study was to investigate the presence of coronary risk factors, the frequency of coronary angiography and methods of treatment analysis in patients over 65 years old.
Among 670 patients hospitalized in our institution, 136 were in the age over 65 years old (20.3%) and they were the study group, 534 patients were in the age below 65 years old and they were the control group.
Total cholesterol, HDL cholesterol, triglycerides, plasminogen inhibitor plasminogen type 1 (PAI-1) and fibrinogen were measured, whereas LDL cholesterol was calculated by means of Friedewald's formula. The frequency of such coronary risk factors as: smoking, arterial hypertension, diabetes and family history of coronary artery disease (CAD), previous myocardial infarction (MI), arterial hypertension and diabetes were analysed. Also were studied results of coronary angiography and qualification for different mode of treatment: pharmacological therapy, percutaneous transluminal coronary angioplasty or coronary artery bypass grafting.
Chi-square test or t-Student test were used.
In the group of patients over 65 years old there were more females. The frequency of arterial hypertension and fibrinogen level were higher in the older group than in the younger one. The frequency of smoking (current and in the past) was higher in the younger patients. The only difference in lipid parameters was significantly higher triglycerides level in the younger group. The percent of people with treated hypercholesterolemia was higher in the younger patients. There were no significant difference in frequency of the other coronary risk factors in both groups. Analysis of family history revealed the lower frequency of stroke, CAD and MI in older patients' relatives. Q wave MI was diagnosed in 32.4% of older patients and in 36.2% of younger ones. Non-Q wave MI was noted in 25.7% and 26.1% respectively. In patients over 65 years old the frequency of unstable CAD was significantly higher than in the younger group. In coronary angiography one vessel changes stenosis was diagnosed in 11.5% of older patients, whereas three vessels stenosis in 40% of these people. Although in both groups invasion treatment was instituted in 60% of the patients, the frequency of coronary surgery was significantly higher in older patients (34.2% vs 22.5%; p < 0.01) whereas the frequency of angioplasty was lower in patients over 65 years old (25.5% vs 44.3%; p < 0.005).
1. In patients over 65 years old the frequency of coronary risk factors was lower than in younger ones. All these factors, except arterial hypertension, seem not to be of such great importance as in younger people. 2. The age alone should not restrict instituting invasion treatment, by which were treated 60% of patients in both groups. 3. In opposition to the control group, in the patients over 65 years old prevailing method of invasion treatment was coronary surgery.