Effect of invasive strategy on long-term mortality in elderly patients presenting with acute coronary syndrome.

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Abstrakt

Tytuł:: Effect of invasive strategy on long-term mortality in elderly patients presenting with acute coronary syndrome.
Autorzy:: Yilmaz S; Cardiology Department, Pamukkale University Hospitals, Pamukkale, Denizli, Turkey. Email: .
Adali MK; Cardiology Department, Pamukkale University Hospitals, Pamukkale, Denizli, Turkey.
Kilic O; Cardiology Department, Pamukkale University Hospitals, Pamukkale, Denizli, Turkey.
Til A; Public Health Department, Pamukkale University, Pamukkale, Denizli, Turkey.
Yaylali YT; Cardiology Department, Pamukkale University Hospitals, Pamukkale, Denizli, Turkey.
Źródło:: Cardiovascular journal of Africa [Cardiovasc J Afr] 2020 Sep/Oct; Vol. 31 (5), pp. 252-256. Date of Electronic Publication: 2020 Jun 22.
Typ publikacji:: Comparative Study; Journal Article
Język:: English
Imprint Name(s):: Original Publication: Durbanville : Clinics Cardive Pub.
MeSH Terms:: Conservative Treatment*/adverse effects
Conservative Treatment*/mortality
Coronary Artery Bypass*/adverse effects
Coronary Artery Bypass*/mortality
Percutaneous Coronary Intervention*/adverse effects
Percutaneous Coronary Intervention*/mortality
Acute Coronary Syndrome/*therapy
Angina, Unstable/*therapy
Cardiovascular Agents/*therapeutic use
Non-ST Elevated Myocardial Infarction/*therapy
ST Elevation Myocardial Infarction/*therapy
Acute Coronary Syndrome/diagnostic imaging ; Acute Coronary Syndrome/mortality ; Age Factors ; Aged, 80 and over ; Angina, Unstable/diagnostic imaging ; Angina, Unstable/mortality ; Cardiovascular Agents/adverse effects ; Cross-Sectional Studies ; Female ; Humans ; Male ; Non-ST Elevated Myocardial Infarction/diagnostic imaging ; Non-ST Elevated Myocardial Infarction/mortality ; Retrospective Studies ; Risk Assessment ; Risk Factors ; ST Elevation Myocardial Infarction/diagnostic imaging ; ST Elevation Myocardial Infarction/mortality ; Time Factors ; Treatment Outcome
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Contributed Indexing:: Keywords: acute coronary syndrome; elderly; mortality
Substance Nomenclature:: 0 (Cardiovascular Agents)
Entry Date(s):: Date Created: 20200707 Date Completed: 20210127 Latest Revision: 20230917
Update Code:: 20240105
PubMed Central ID:: PMC8762820
DOI:: 10.5830/CVJA-2020-011
PMID:: 32628742
: Czasopismo naukowe

Objective: The elderly have the highest incidence of cardiovascular disease and frequently present with acute coronary syndrome (ACS). In this study, our aim was to evaluate the effect of an invasive strategy on long-term mortality in patients of 80 years and older presenting with ACS.
Methods: Patients who were admitted to hospital with ACS were recruited using appropriate ICD codes in the computerised hospital data system. After exclusion of patients below 80 years old, the remaining 156 patients were involved in the final analyses. Ninety-four of 156 patients (60.3%) underwent coronary angiography and they constituted the invasive-strategy group, whereas the remaining 62 (39.7%) patients were treated medically and they constituted the conservative-strategy group.
Results: Median follow-up duration of patients was 8.5 (0-61) months. Total mortality at the end of the follow-up period was 24 (25.5%) patients in the invasive-strategy group and 30 (48.4%) in the conservative-strategy group (p = 0.006). According to Cox regression analysis, the invasive strategy (OR: 0.26, 95% CI: 0.12-0.56, p = 0.001), presentation with ST-segment elevation myocardial infarction (OR: 7.76, 95% CI: 1.74-34.57, p = 0.002), low ejection fraction below 40% (OR: 3.11, 95% CI: 1.43-6.76, p = 0.004), heart rate (OR: 0.98, 95% CI: 0.96-0.99, p = 0.013) and GRACE risk score between 150 and 170 (OR: 7.76, 95% CI: 1.74-34.57, p = 0.002) were related to long-term mortality.
Conclusions: Our results show the benefit of the invasive strategy on mortality rate in elderly patients over 80 years old and presenting with ACS.

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