Background: Limited data are available in octogenarian patients, and most of these studies excluded older patients with significant co morbid conditions. This is an observational study of octogenarians admitted for acute coronary syndrome (ACS). Purpose: We sought to investigate clinical characteristics, treatment and outcome of octogenarian patients during hospital stay for ACS in transitional country. Methods: Data were collected in the ISACS-TC registry (ClinicalTrials.gov,NCT01218776) from October 2010 to February 2015: there were 992 patients ≥80 years old, consecutive admitted with a diagnosis of ACS at 58 hospitals in 11 Eastern European countries. Patients who had undergone fibrinolysis and coronary artery bypass grafting (CABG), were also excluded. In-hospital mortality was the primary end-point. Results: Octogenarian patients represent 7.5% of ISACS-CT population. Among these, 56.7% were admitted with a diagnosis of ST segment elevation myocardial infarction (STEMI). The mean age of the study population was 83.5±3.5 years and 51.6% of the patients were women. Female, less frequently than male, had history of myocardial infarction, peripheral artery disease (PAD), prior CABG and chronic kidney disease. They were less likely to have smoking and former smoking status. There was no difference in the rates of death between male (18.5%) and female (19.2%) patients. Octogenarian patients undergoing invasive coronary procedures had significantly lower rate of death (12.5% vs 22.2 P<0.001). In multivariable regression analysis, cardiovascular death in the octogenarians was associated (p<0.05) with age ≥85 years (odds ratio [OR] 1.82), prior PAD (OR: 4.92) and Killip class ≥2 (OR 4.41). Invasive coronary procedures was an independent significant protective factor on hospital mortality (OR 0.43). Conclusions: Octogenarian ACS patients have a high mortality rate which can be reduced by invasive coronary procedures. Age is relevant in the prognosis of ACS, but its importance should be considered not secondary to other clinical factors.
B. Ricci, E. Cenko, Z. Vasiljevic, M. Dorobantu, D. Trninic, B. Knezevic, et al. (2015). In-hospital outcome in octogenarians with acute coronary syndrome undergoing invasive coronary procedures. EUROPEAN HEART JOURNAL, 36(suppl 1), 1024-1025.
In-hospital outcome in octogenarians with acute coronary syndrome undergoing invasive coronary procedures
RICCI, BEATRICE;CENKO, EDINA;MANFRINI, OLIVIA;BUGIARDINI, RAFFAELE
2015
Abstract
Background: Limited data are available in octogenarian patients, and most of these studies excluded older patients with significant co morbid conditions. This is an observational study of octogenarians admitted for acute coronary syndrome (ACS). Purpose: We sought to investigate clinical characteristics, treatment and outcome of octogenarian patients during hospital stay for ACS in transitional country. Methods: Data were collected in the ISACS-TC registry (ClinicalTrials.gov,NCT01218776) from October 2010 to February 2015: there were 992 patients ≥80 years old, consecutive admitted with a diagnosis of ACS at 58 hospitals in 11 Eastern European countries. Patients who had undergone fibrinolysis and coronary artery bypass grafting (CABG), were also excluded. In-hospital mortality was the primary end-point. Results: Octogenarian patients represent 7.5% of ISACS-CT population. Among these, 56.7% were admitted with a diagnosis of ST segment elevation myocardial infarction (STEMI). The mean age of the study population was 83.5±3.5 years and 51.6% of the patients were women. Female, less frequently than male, had history of myocardial infarction, peripheral artery disease (PAD), prior CABG and chronic kidney disease. They were less likely to have smoking and former smoking status. There was no difference in the rates of death between male (18.5%) and female (19.2%) patients. Octogenarian patients undergoing invasive coronary procedures had significantly lower rate of death (12.5% vs 22.2 P<0.001). In multivariable regression analysis, cardiovascular death in the octogenarians was associated (p<0.05) with age ≥85 years (odds ratio [OR] 1.82), prior PAD (OR: 4.92) and Killip class ≥2 (OR 4.41). Invasive coronary procedures was an independent significant protective factor on hospital mortality (OR 0.43). Conclusions: Octogenarian ACS patients have a high mortality rate which can be reduced by invasive coronary procedures. Age is relevant in the prognosis of ACS, but its importance should be considered not secondary to other clinical factors.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
