Risk factors associated with early symptoms of acute coronary syndrome in the elderly

Introduction & Objective : Acute coronary syndrome is health threatening and a major cause of mortality in elderly. Recognizing factors associated with symptoms of acute coronary syndrome are important in reduction of consequences of delayed diagnosis of symptoms. This study proposes to examine factors associated with early symptoms among elder with ACS. Material & Methods: This is a cross sectional study. The early symptoms of 446 patients with diagnosis of ACS were assessed eight hospitals at Tehran-Iran (2006). Symptoms categorized as typical and atypical symptoms. Correlation between demographic and risk factors with age group and early symptoms were assessed using the chi-square test. Multivariate logistic regression analyses were conducted to determine factors related to early symptoms acute coronary syndrome. Results: Elder (&ge65yr) and younger (&le65) have a statistically significant difference in chest symptoms, arm pain, jaw or neck pain and dyspnea (P<0.001). Palpitation was the most common reported symptom in patients over 65 years (38.19%) and less than 65 years (37.08%). Multivariate logistic regression showed that elder patients with a history of hypertension (P=0.002, OR=0.43), smoking (P= 0.019, OR=0.51), and obesity (P=0.011, OR=0.69) have less chance to experience the early symptoms compared to younger patients, respectively. Conclusion: Obesity, hypertension and smoking are risk factors which lower the initial symptoms of acute coronary syndrome in the elderly.Nurses and physicians should be careful attention in history taking of elderly suspected to acute coronary syndrome.