Features of myocardial infarction with ST segment elevation in patients of the older age group
Background: Despite the fact that the incidence of myocardial infarction remains extremely high, and the average age of patients (given the increase in average life expectancy) is in the elderly group, there is currently insufficient data on the course of the disease in this age group. Most clinical studies focus on the middle-aged group (45-60 years). The aim of the study: Analysis of literature data on the features of the course of myocardial infarction in patients of an older age group, as well as the near and distant prognosis of survival and social rehabilitation. Materials and methods: The authors have analyzed modern domestic and foreign literature, including those presented in modern scientific databases PubMed, E-library, Web of Science, and Scopus, on the characteristics of myocardial infarction in elderly patients, including cognitive disorders. Results: Thanks to the few scientific studies that involved MI in people of an older age group, it was found that atypical manifestations of myocardial infarction are more common in patients of an older age group, which complicates the diagnosis of this disease and slows down timely treatment. It is also clear that in elderly people without polymorbid pathology, the strategy of thrombolytic therapy against percutaneous intervention (PCI) did not show a significant difference in the long-term prognosis, however, in patients with polymorbid pathology there is a huge advantage to the strategy of primary PCI, however, despite these reliable facts, a large group of elderly and senile patients do not receive the necessary medical intervention due to various unreasonable reasons, which sharply worsens the short-term and long-term prognosis in such patients. Also, a relationship was directly established in patients with dementia with MI. These data are not enough to draw deep conclusions. Conclusion: The characteristics of MI in patients of older age groups need further scientific research. In the near and long-term prognosis in patients of older age groups, some questions remain about the advantage of primary PCI over the conservative tactics of administering MI in elderly and senile patients without multifactorial pathology. The question of the tactics of introducing “fragile” patients and patients suffering from various forms of cognitive dysfunction also remains open.
Osipova OA, Bukatov VV. Features of myocardial infarction with ST segment elevation in patients of the older age group. Research Results in Biomedicine. 2020;6(3):402-416. Russian.
DOI: 10.18413/2658-6533-2020-6-3-0-10
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