Document Type : Review Article
Authors
1 Department of Health Promotion and Education, School of Health, Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermansha, Iran
2 Obstetrics and Gynecology, Department of Obstetrics and Gynecology, School of Medicine, Motazedi Hospital Kermanshah University of Medical Sciences, Kermanshah, Iran
3 School of Medical Sciences, Khomein Faculty of Medical Sciences, Khomein, Iran
4 Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
Abstract
BACKGROUND: Myocardial Infarction (MI) refers to the destruction and death of cells in the myocardium of the heart. Its prevalence increases with age due to changes in the cardiovascular system. The aim of the present study was to combine, summarize, standardize, resolve inconsistencies in the results of studies, and investigate the impact of potential factors on the prevalence rate of MI in the elderly through a systematic review and meta-analysis.
METHODS: This systematic review and meta-analysis was conducted from 1987 to March 2022. All relevant published studies were searched in PubMed, Embase, Scopus, Web of Science (WoS) databases, and Google Scholar search engine using related MeSH/Emtree and Free Text words. The heterogeneity among studies was quantified using the I2 index.
RESULTS: In the initial search, 35453 studies were identified. After eliminating irrelevant studies, finally, 29 articles with a sample size of 3279136 subjects were included in the meta-analysis. After combining the results of the studies included in the meta-analysis, the total prevalence of MI in the elderly was estimated to be 17.6% (95% CI: 12.8 - 23.7%), 16.1% (95% CI: 11.0 - 22.8%) in males, and 12.5% (95% CI: 9.2 - 16.8%) in females. The prevalence of MI increased with the year of publication and the mean age of the elderly (P < 0.001).
CONCLUSION: The results showed that due to the high prevalence of myocardial infarction (MI) in the elderly, it should be addressed within healthcare systems and policy makers should pay more attention to prevention of MI. However, considering the inclusion of heterogeneous studies, the pooled estimation should be interpreted with caution.
Keywords
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13. Trzos E, Uznańska B, Rechciński T, Krzemińska-Pakuła M, Bugała M, Kurpesa M. Myocardial infarction in young people. Cardiol J. 2009;16(4):307-11.
14. Félix-Redondo FJ, Grau M, Fernández-Bergés D. Cholesterol and cardiovascular disease in the elderly. Facts and gaps. Aging Dis 2013; 4(3):154-69.
15. Jackson CF, Wenger NK. Cardiovascular disease in the elderly. Rev Esp Cardiol (Engl Ed). 2011;64(8):697-712. https://doi.org/10.1016/j.rec.2011.05.003
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19. Sheifer SE, Gersh BJ, Yanez ND, Ades PA, Burke GL, Manolio TA. Prevalence, predisposing factors, and prognosis of clinically unrecognized myocardial infarction in the elderly. J Am Coll Cardiol. 2000;35(1):119-26. https://doi.org/10.1016/S0735-1097(99)00524-0
20. Rathore SS, Berger AK, Weinfurt KP, Schulman KA, Oetgen WJ, Gersh BJ, et al. Acute myocardial infarction complicated by atrial fibrillation in the elderly: prevalence and outcomes. Circulation. 2000;101(9):969-74. https://doi.org/10.1161/01.CIR.101.9.969
21. Aronow WS. Prevalence of presenting symptoms of recognized acute myocardial infarction and of unrecognized healed myocardial infarction in elderly patients. Am J Cardiol. 1987;60(14):1182.
https://doi.org/10.1016/0002-9149(87)90418-8
22. Mehta RH, Rathore SS, Radford MJ, Wang Y, Wang Y, Krumholz HM. Acute myocardial infarction in the elderly: differences by age. J Am Coll Cardiol. 2001;38(3):736-41. https://doi.org/10.1016/S0735-1097(01)01432-2
23. Rathore SS, Gersh BJ, Berger PB, Weinfurt KP, Oetgen WJ, Schulman KA, et al. Acute myocardial infarction complicated by heart block in the elderly: prevalence and outcomes. Am Heart J. 2001;141(1):47-54. https://doi.org/10.1067/mhj.2001.111259
24. Lusiani L, Perrone A, Pesavento R, Conte G. Prevalence, clinical features, and acute course of atypical myocardial infarction. Angiology. 1994;45(1):49-55. https://doi.org/10.1177/000331979404500107
25. O’Neal WT, Sangal K, Zhang ZM, Soliman EZ. Atrial fibrillation and incident myocardial infarction in the elderly. Clin Cardiol. 2014;37(12):750-5. https://doi.org/10.1002/clc.22339
26. Brugts JJ, Knetsch AM, Mattace-Raso FU, Hofman A, Witteman JC. Renal function and risk of myocardial infarction in an elderly population: the Rotterdam Study. Arch Intern Med. 2005;165(22):2659-65. https://doi.org/10.1001/archinte.165.22.2659
27. Nadelmann J, Frishman WH, Ooi WL, Tepper D, Greenberg S, Guzik H, et al. Prevalence, incidence and prognosis of recognized and unrecognized myocardial infarction in persons aged 75 years or older: the Bronx Aging Study. Am J Cardiol. 1990;66(5):533-7. https://doi.org/10.1016/0002-9149(90)90477-I
28. Duan Y, Mo J, Klein R, Scott IU, Lin H-M, Caulfield J, et al. Age-related macular degeneration is associated with incident myocardial infarction among elderly Americans. Ophthalmology. 2007;114(4):732-7. https://doi.org/10.1016/j.ophtha.2006.07.045
29. Dangelser G, Gottwalles Y, Huk M, De Poli F, Levai L, Boulenc J-M, et al. Infarctus du myocarde du sujet de plus de 75 ans: Données d’un registre multicentrique régional. Presse Med. 2005;34(14):983-9. https://doi.org/10.1016/S0755-4982(05)84096-5
30. Barbier CE, Nylander R, Themudo R, Ahlström H, Lind L, Larsson E-M, et al. Prevalence of unrecognized myocardial infarction detected with magnetic resonance imaging and its relationship to cerebral ischemic lesions in both sexes. J Am Coll Cardiol. 2011;58(13):1372-7. https://doi.org/10.1016/j.jacc.2011.06.028
31. Khera S, Kolte D, Palaniswamy C, Mujib M, Aronow WS, Singh T, et al. ST-elevation myocardial infarction in the elderly-temporal trends in incidence, utilization of percutaneous coronary intervention and outcomes in the United States. Int J Cardiol. 2013;168(4):3683-90. https://doi.org/10.1016/j.ijcard.2013.06.021
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