Clinical and angiographic aspects of acute coronary syndrome in patients over 80 in the Republic of Buryatia

Acute coronary syndrome (ACS) is the most common and most dangerous clinical manifestation of coronary heart disease. 60% of deaths due to ACS are among people over 75. Management of acute coronary syndrome in elderly people is extremely difficult due to high comorbidity, cognitive impairment, high risk of complications and mortality. Currently, there is no enough information about the clinical features of ACS in this age group, which complicates diagnosis, limits treatment options and requires the use of invasive methods.We have studied age, gender, clinicopathologic and ethnic characteristics of 100 patients over 80 years with acute coronary syndrome. Females predominated in the examinedgroup (68%), however the gender ratio changed with increasing age, and the proportion of men and women at the age group over 90 was equal.Before the development of acute coronary syndrome, the majority of patients (73%) had a history of coronary heart disease (CHD) with a long continuation (more than 10 years) (45%). Treatment of coronary heart disease at the outpatient stage was characterized by a low frequency of medication intake and application of myocardial revascularization. ACS occurred with pain in 74% of cases; a painless atypical form was observed in 19% patients. 63% of patients had NSTE-ACS. Acute myocardial infarction was diagnosed in 61% of patients, unstable angina - in 39%. Multiple lesions of the coronary arteries were in 75% of patients, single-vessel disease - in 25%. The frequency of clinical variants and outcomes of ACS did not depend on the degree of coronary artery damage.There were no statistically significant differences in the course of ACS and the degree of damage to the coronary arteries in patients of Buryat and Russian ethnicity.