| Background: Coronary heart disease (CHD) is mainly caused by coronary artery stenosis even occlusion induced by coronary atherosclerosis leading to ischemia and hypoxia of myocardium, which is the first killer of human being. According to statistics, the most common cause of CHD is death and acute myocardial infarction (AMI) is the most serious type. AMI is caused by stenosis or spasm of coronary artery which result in the distal vessels supplying regions of myocardial hypoxia leading to myocardial ischemic injury with clinical symptoms as chest pain (but some patients had no pain) complicated with heart failure, arrhythmia even shock, AIM is also the main reason of sudden cardiac death. It is reported that 8.5 million people died from AMI each year all over the world. In recent years, the incidence rate of AMI in our country has the tendency to increase gradually year by year. With the advancement of science and technology, various methods such as the initial and intravenous thrombolysis especially the percutaneous coronary intervention (PCI) in the treatment of AMI were developed, which improved made the therapy of AMI in reperfusion the coronary artery. The long-term prognosis of patient who suffered AMI were improved apparently by PCI because of its high patency rate of infarct-related artery (IRA), fewer bleeding complications which were compared with the thrombolytic therapy. Despite these various measures droped the treatment and diagnosis of sudden cardiac death rate drastically, the incidence of elderly patients with acute myocardial infarction and mortality was still significantly increased. The majority of elderly patients with AMI whose symptoms were not typical or even painless and were often covered by symptoms of other systems which were mainly due to the increase of age, cerebral arteriosclerosis, coronary heart disease, cardiac autonomic nervous system changes, a number of chronic diseases and complications, depress of sensitivity and responsiveness. AMI in elderly patients were often misdiagnosed, therefore it is important to analyze the initial symptoms of senile AMI. Thus, the key point in the remedy of senile AMI people includ careful observation, accurate early diagnosis, aggressive salvage and effective care .Purpose: This research is to analyze the correlations among the risk factors, clinical manifestations, arrhythmia attack situation and angiographic situation of coronary artery in senile AMI patients which compared to youth and middle-aged AMI patients and summarized the clinical features of senile AMI patients so as to provide references in the diagnosis and treatment of senile AMI patients in order to decrease the mortality rate and to improve the prognosis.Methods: 144 patients whose diagnoses were AMI were included in the research and were divided into two groups according to age as an senile group (≥65 years) including 75 cases (45 male and 30 female) and a un-senile group (<65 years) including 69 cases(53 male and 16 female). Clinical data such as risk factors of CHD, clinical performances, results of angiographic situation of coronary artery and auxiliary examination results were compared between the tow groups so as to summarize the characteristic of senile AMI patients.Result:①The morbidity rate of AMI of female in senile group is higher than that of the un-senile group and the difference possess statistical significance (P<0.05). There were no difference in the number of patients with AMI complicated with hypertension, diabetes and hyperlipidemia between the two groups(all P>0.05).②The number of patients in senile group who were complicated with hypertension, diabetes and hyperlipidemia developed triple- vessel lesion is significantly higher than that of the patients with double-vessel or single-vessel lesion(P<0.05).③The morbidity rate of AMI in senile group after a few obvious examples are typical chest pain is higher than that of the un-senile group, which merged with breath and falling, gut reaction, the number of cases is higher than that of the un-senile group, in the quiet without incentive circumstances of the occurrence of data is also significantly higher than that of the un-senile group and the difference possess statistical significance significant(all P<0.05).④The two groups of the victim after arrhythmias, the number of the morbidity rate of AMI in senile group occered ventricular arrhythmia and ChamberⅡfor the block is significantly higher than that of the un-senile group (P<0.01 and P<0.05), but the two groups of the sexual arrhythmias rate than difference has no statistical significance significant (P>0.05).⑤The two groups of infarction areas related to the left, the main artery(LAX,LAD,LCX,RCA)the distribution of no statistics compare the differences(all P>0.05), but the two groups of patients treated to a different extent coronary artery, the morbidity rate of AMI in senile group three is the largest in the proportion, and the difference possess statistical significance, and coronary artery disease is related to age in(rs=0.198,P=0.017<0.05).Conclusion: Senile AMI patients were more sensitive to some risk factors such as hypertension, diabetes and hyperlipidemia developing multi-vessel lesion. No obvious inducement factors were found in senile AMI patients; most of them were performed as atypical chest pain and complicated with dyspnea, heart failure and consciousness disorders. Senile AMI patients possess a high incidence rate of ventricular arrhythmia and second degree atrioventricular block leading to an aggravation of hemodynamics and heart function so the senile AMI patients are vulnerable to suffer heart failure and sudden cardiac death.The pathologic degree of the coronary artery in AMI patients has positive correlation with age. Senile patients have a high proportion of multi-vessel lesion and this is possibly related to the complexity and long-term and diffuse and chronic lesions of coronary artery caused by scleratheroma.
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