[ relationship between risk factors and primary symptoms of acute coronary syndrome in below and above 65 years old]

ABSTRACT

Acute coronary syndrome is health threatening and a major cause of mortality among elderly people. Recognizing factors associated with symptoms of acute coronary syndrome are important in the reduction of consequences of delayed diagnosis of symptoms. This study proposes to determine factors associated with early symptoms among elderly people with ACS. In this cross sectional study, data collecting instrument included a checklist of early symptoms of acute coronary syndrome. The early symptoms of 446 patients with diagnosis of ACS were assessed in eight hospitals in Tehran-Iran, 2006. Symptoms were categorized as typical and atypical. 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. Elderly patients and younger ones showed 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 younger than 65 years [37.08%]. Multivariate logistic regression showed that elderly 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] had less chance to experience the early symptoms compared to younger patients, respectively. Obesity, hypertension and smoking are risk factors which lower the initial symptoms of acute coronary syndrome in the elderly .Nurses and physicians should pay a careful attention to history taking of the elderly suspected to acute coronary syndrome.