Older adults (≥65 years) with chest pain had a higher risk of 30-day death or MI compared to young adults (aOR 1.57; 95% CI 1.17-2.12), after adjusting for comorbidities and hs-cTn.
Observational (n=40,979)
Yes
Does older age increase the risk of 30-day death, MI, and hospitalization in patients presenting to the ED with chest pain, after adjusting for comorbidities and hs-cTn?
Older and middle-aged adults presenting to the ED with chest pain have higher adjusted rates of 30-day death, MI, and hospitalization compared to young adults, even after accounting for comorbidities and hs-cTn.
Effect estimate: aOR 1.57 (95% CI 1.17-2.12)
Absolute Event Rate: 7.3% vs 0.8%
ABSTRACT Background This study aims to determine if differences in age affect safety and healthcare utilization among patients with chest pain in a multisite US ED cohort, after accounting for comorbidities and high‐sensitivity troponin (hs‐cTn). Methods We conducted a multisite observational study using the Wake Forest Chest Pain Registry, which included patients ≥ 18 years old with chest pain across 25 EDs (01/01/2021 to 12/31/2021). Each site used an hs‐cTn chest pain protocol. Patients were categorized as older (≥ 65 years), middle‐aged (46−64 years), or young (18−45 years). The primary safety outcome was death or MI at 30 days. The primary healthcare utilization outcome was 30‐day hospitalization. Multivariable logistic regression models assessed the association between age and outcomes, adjusting for sex, race, ethnicity, obesity, smoking, rurality, coronary disease, diabetes, hypertension, hyperlipidemia, insurance, site, and hs‐cTn, with young patients as the reference. Results Among 40 979 patients, 25.1% were older, 39.7% middle‐aged, and 35.2% young. At 30 days, death or MI occurred in 7.3% (750/10 298) of older, 3.8% (611/16 260) of middle‐aged, and 0.8% (108/14 421) of young patients. After adjustment, death or MI at 30 days was more common among older (aOR 1.57, 95% CI 1.17−2.12) and middle‐aged (aOR 1.57, 95% CI 1.22‐2.02) patients. Hospitalization at 30 days occurred in 56.3% (5799/10 298) of older, 35.4% (5761/16 260) of middle‐aged, and 12.8% (1849/14 421) of young patients. With adjustment, hospitalization remained more common among older (aOR 2.51, 95% CI 2.27−2.78) and middle‐aged (aOR 1.93, 95% CI 1.80−2.07) patients. Conclusion After adjusting for comorbidities and hs‐cTn results, older adults had higher rates of death or MI and hospitalization at 30 days.
Ashburn et al. (2026) conducted an observational in Chest pain (n=40,979). Older age (≥ 65 years) vs. Young age (18-45 years) was evaluated on Death or MI at 30 days (aOR 1.57, 95% CI 1.17-2.12). Older adults (≥65 years) with chest pain had a higher risk of 30-day death or MI compared to young adults (aOR 1.57; 95% CI 1.17-2.12), after adjusting for comorbidities and hs-cTn.