Representation of Elderly Persons and Women in Published Randomized Trials of Acute Coronary Syndromes

Abstract

Demographic changes in the US population have resulted in an increase in the numbers of elderly patients and women seeking treatment for cardiovascular disease. In 1975, 24% of patients hospitalized for myocardial infarction (MI) were at least 75 years old. By 1995, this percentage had risen to 37%.¹ Similarly, the percentage of women MI patients has risen from 35% in 1975 to 43% in 1995.¹ Beyond their high prevalence in the MI population, elderly persons and women fare worse following cardiac events. For example, up to 60% of MI deaths occur in patients aged 75 years or older.² Elderly patients and women also experience more MI complications including heart failure, shock, and ventricular rupture.³ Despite these higher risks, published cardiovascular clinical trials have historically underenrolled elderly persons and women relative to younger persons and men.^2,4