| Summary: | Background: The high prevalence of acute coronary syndromes (ACS) and the imminent transition of a proportion of the population into the geriatric age group are issues vital to the health-care delivery system. We wished to compare the risk factors, clinical presentation, echocardiographic and angiographic findings, complications, and in-hospital outcomes of ACS in the elderly and the younger population and identify the predictors of mortality in the elderly. Materials and Methods: This observational cross-sectional study was performed on patients hospitalized with ACS over a 12-month period. Demographic, clinical, and laboratory data of all included patients were analyzed after categorizing them as Groups I (>60 years; n = 188) and II (<60 years; n = 123). Results: Congestive heart failure (n = 64; 20.6%), shock (n = 19; 6.1%), and arrhythmias (n = 9; 2.9%) were observed at presentation in the 311 patients studied. Intervention was not undertaken in 18/311 (5.8%) either due to poor general condition or refusal by the patients' attendants. The risk factors significantly associated (P < 0.05) in Group II included male gender, tobacco and alcohol use, central obesity, dyslipidemia, and a positive family history of coronary artery disease (CAD). Group II had significantly higher (P < 0.05) Killip class, heart failure, and shock at presentation and mortality. Conclusion: The risk factors of CAD differ in the elderly; also they are predisposed to adverse outcome as compared to the younger people. Mortality among the elderly is significantly higher in those with arrhythmias, shock, low diastolic blood pressure, and/or congestive heart failure with advanced Killip class.
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