Đặc điểm lâm sàng, cận lâm sàng ở bệnh nhân cao tuổi bị nhồi máu cơ tim cấp có ST chênh lên được can thiệp động mạch vành qua da thì đầu

Abstract

Objective: To describe the clinical and paraclinical characteristics of patients aged ≥ 75 years with ST-elevation myocardial infarction (STEMI). Subject and method: A cross-sectional descriptive study was conducted on 104 patients aged ≥75 years diagnosed with STEMI and indicated for percutaneous coronary intervention (PCI) at Vietnam National Heart Institute - Bach Mai Hospital, Hanoi Heart Hospital, and Huu Nghi Hospital during the period from 2018 to 2021. Result: The average age was 81.2 ± 4.8 years, with the 75-79 age group accounting for the highest proportion (40.4%) and males comprising 64.4%. The most common risk factors were hypertension (90.4%), dyslipidemia (68.3%), and diabetes mellitus (36.5%). Clinically, the majority of patients presented with dyspnea (89.4%) and fatigue (93.3%), with Killip class III-IV accounting for 13.4%. Paraclinical findings showed median CK-MB of 98.9U/L, troponin T of 2738.5ng/mL, and NT-proBNP of 1073.5ng/dl. Electrocardiogram findings indicated predominantly sinus rhythm (90.4%) with a mean ST-segment elevation of 2.82mm. The most common infarction sites were inferior (39.4%) and anteroseptal (38.5%). Single-vessel coronary artery lesions were most frequent (70.2%), with the left anterior descending artery being the most commonly affected site (50.0%). Conclusion: Elderly patients (≥ 75 years) with STEMI exhibit diverse clinical characteristics, with predominant sinus rhythm and frequent left anterior descending artery involvement on coronary angiography.