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Elderly are more likely to have non-diagnostic ECGs. The proportion of patients > 85 years of age with NSTEACS who had non-diagnostic ECGs was 43% vs. 23% for patients < 65 years of age. [Elderly are also more likely to have LBBB as well as prior evidence of MI, either one of which can cause some problems with interpretation of acute cardiac ischemia.] The lack of CP combined with non-diagnostic ECGs probably leads to delays and under-treatment of many of these patients.
[Alexander KP, et al. Acute coronary care in the elderly, part I: Non-ST-segment elevation acute coronary syndromes. Circulation 2007;115:2549-2569.]