OBJECTIVES: The study examined differences in presentation and outcome between elderly (> or =70 years) and very elderly (> or =80 years) patients hospitalized for acute coronary syndromes (ACS). BACKGROUND: The elderly constitute an increasingly important sector of patients with ACS but have been underrepresented in many therapeutic trials. METHODS: We compiled a registry of 449 consecutive patients, 251 elderly (70 to 79 years) (septuagenarians, group 1) and 198 very elderly (> or =80 years) (group 2), to examine outcomes in relation to baseline characteristics and treatment. We recorded survival over a period of 24 +/- 4 months and rehospitalization and symptomatic status at 16 +/- 4 months. RESULTS: At index hospitalization, the older cohort (group 2) more often had acute myocardial infarction (35% vs. 9.7%, p < 0.0001), heart failure (33.3% vs. 19.4%, p < 0.001), and renal dysfunction (21.6% vs. 12.3%, p = 0.01). They were less likely to undergo coronary angiography (29.3% vs. 43.8%, p = 0.002), but those selected for angiography more often underwent revascularization so that revascularization rates were similar (22.7% group 2 vs. 24.3% group 1, p = NS). Two-year survival rate was poorer in group 2 (67.4 +/- 3.5% vs. 83.5 +/- 2.5% in group 1, p < 0.0001). Repeat rehospitalization was similar (53.0% vs. 48.2%, respectively, p = 0.31), but improvement in well-being of survivors was greater (60.0% vs. 46.3%, p = 0.01). CONCLUSIONS: The study demonstrated important differences between elderly (70 to 79 years) and very elderly (> or =80 years) patients hospitalized with ACS. The older cohort was sicker on admission and had poorer outcome, but a subgroup selected for angiography and possible intervention had two-year outcomes similar to the younger cohort.
OBJECTIVES: The study examined differences in presentation and outcome between elderly (> or =70 years) and very elderly (> or =80 years) patients hospitalized for acute coronary syndromes (ACS). BACKGROUND: The elderly constitute an increasingly important sector of patients with ACS but have been underrepresented in many therapeutic trials. METHODS: We compiled a registry of 449 consecutive patients, 251 elderly (70 to 79 years) (septuagenarians, group 1) and 198 very elderly (> or =80 years) (group 2), to examine outcomes in relation to baseline characteristics and treatment. We recorded survival over a period of 24 +/- 4 months and rehospitalization and symptomatic status at 16 +/- 4 months. RESULTS: At index hospitalization, the older cohort (group 2) more often had acute myocardial infarction (35% vs. 9.7%, p < 0.0001), heart failure (33.3% vs. 19.4%, p < 0.001), and renal dysfunction (21.6% vs. 12.3%, p = 0.01). They were less likely to undergo coronary angiography (29.3% vs. 43.8%, p = 0.002), but those selected for angiography more often underwent revascularization so that revascularization rates were similar (22.7% group 2 vs. 24.3% group 1, p = NS). Two-year survival rate was poorer in group 2 (67.4 +/- 3.5% vs. 83.5 +/- 2.5% in group 1, p < 0.0001). Repeat rehospitalization was similar (53.0% vs. 48.2%, respectively, p = 0.31), but improvement in well-being of survivors was greater (60.0% vs. 46.3%, p = 0.01). CONCLUSIONS: The study demonstrated important differences between elderly (70 to 79 years) and very elderly (> or =80 years) patients hospitalized with ACS. The older cohort was sicker on admission and had poorer outcome, but a subgroup selected for angiography and possible intervention had two-year outcomes similar to the younger cohort.
Authors: David H Fitchett; Bjug Borgundvaag; Warren Cantor; Eric Cohen; Sanjay Dhingra; Stephen Fremes; Milan Gupta; Michael Heffernan; Heather Kertland; Mansoor Husain; Anatoly Langer; Eric Letovsky; Shaun G Goodman Journal: Can J Cardiol Date: 2006-06 Impact factor: 5.223
Authors: Paul Michael Haller; Bernhard Jäger; Serdar Farhan; Günter Christ; Wolfgang Schreiber; Franz Weidinger; Thomas Stefenelli; Georg Delle-Karth; Alfred Kaff; Gerald Maurer; Kurt Huber Journal: Wien Klin Wochenschr Date: 2018-03 Impact factor: 1.704
Authors: Alexander D Simms; Philip D Batin; John Kurian; Nigel Durham; Christopher P Gale Journal: J Geriatr Cardiol Date: 2012-06 Impact factor: 3.327