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Objectives Little is known about the mortality rate of ST-segment elevation myocardial infarction (STEMI) in older people form low- and middle-income countries. Therefore, this study aims to investigate the predictors of one-year mortality in older people with STEMI in Kermanshah, Iran. Methods & Materials This is a cohort study that was conducted on 421 older patients with STEMI admitted to Imam-Ali Hospital in Kermanshah from July 3, 2018, to December 21, 2019. Descriptive statistics were used to report the risk factors, and univariate and multiple Cox proportional-hazards model were used to investigate predictors of one-year mortality. Results The patients had a mean age of 73.51±6.73 years. The majority of them were male (67.5%), residents of Kermanshah (74.9%), and illiterate (60.8%). Reperfusion therapy was administered for 86.0% of patients (50.4% with percutaneous coronary intervention [PCI] and 30.4% with thrombolytic treatment). The follow-up period was 350.62 person-years. In one year, 76 patients (18.5%) died, of whom 12.4% had PCI, 16.1% thrombolytic treatment, and 0.38% no reperfusion therapy. Independent predictors of mortality were: No reperfusion therapy (hazard ratio [HR]: 2.42, 95% CI, 1.14%, 5.11%) and glomerular filtration rate (HR:0.97, 95% CI, 0.94%, 0.99%). Conclusion In this study, the older patients with STEMI treated by PCI had a lower one-year mortality rate. It is recommended to establish a comprehensive STEMI network to enhance timely reperfusion for these patients and improve their health literacy.

Objectives Older diabetic patients with myocardial infarction (MI) are vulnerable group. This study aims to compare the prevalence of risk factors, type of reperfusion therapy, and mortality in diabetic and non-diabetic elderly with MI. Methods & Materials This is a cohort study. The statistical population consists of all older adults (age ≥60 years), whose information was available in the ST-segment elevation myocardial infarction (STEMI) registry system of Imam Ali hospital in Kermanshah, Iran from July 2016 to January 2020. Of these, 1460 participants with STEMI were selected based on the inclusion criteria and divided into two diabetic and non-diabetic groups. Their information was recorded by trained nurses using a checklist surveying demographic information, medical records, cardiovascular disease risk factors, clinical and diagnostic tests, type of treatment, and death at the time of admission, hospitalization and discharge. Data analysis was performed using descriptive statistics, independent t-test, Mann-Whitney and chi-square test in Stata software, version 14. P

Objectives The prevalence of cardiovascular risk factors is different in the elderly and middle-aged. Therefore the present study aims to compare the prevalence of risk factors affecting ST-elevation myocardial infarction (STEMI), type of treatment, and mortality rate in these two groups. Methods & Materials This retrospective cohort study included 1 071 elderly and middle-aged ST-elevation myocardial infarction (STEMI) patients who had referred to Kermanshah Imam Ali Hospital for 23 months from January 2017 to November 2019. Demographic information, cardiovascular risk factors, type of treatment, and mortality were examined. Data were analyzed with descriptive statistics, independent t test, and Chi-square test in Stata software version 14 with a significance level of 0.05. Results In the present study, the prevalence of risk factors, including smoking, high triglyceride, overweight, and obesity in the middle-aged group was significantly more than the elderly group (P < 0.05). The low-density lipoprotein (LDL) mean (mg/dL) in the middle-aged group (99.26 ± 71.69) was significantly higher than the elderly group (96.29 ± 8.5) (P < 0.05). The rate of primary angioplasty use was higher in the middle-aged (55.31%) than in the elderly (48.52%). Other results indicated that the overall mortality rate in the elderly (15.7%) was higher than in the middle-aged (4.4%) (P < 0.001). The prevalence of myocardial infarction, stroke, hypertension, hyperlipidemia, and glomerular filtration rate (GFR) < 60 was significantly higher in the elderly group compared to the middle-aged (P < 0.05). Conclusion The prevalence of low glomerular filtration rate (GFR), hyperlipidemia, and hypertension, myocardial infarction and stroke is higher in the elderly than in the middle-aged, while the prevalence of vital risk factors, such as smoking, triglycerides, overweight, and obesity in the middle-aged group is significantly higher than the elderly. If these risk factors are planned and controlled in middle age, people will be less at risk for myocardial infarction in aging.