BACKGROUND: Age is associated with outcomes in non-ST-segment elevation myocardial infarction; however, less is known about rehospitalization or death among elderly survivors. We aimed to evaluate mortality and cause-specific rehospitalization rates in this growing population of older adults with ischemic heart disease. METHODS: We linked 36,711 patients aged ≥65 years who survived an index non-ST-segment elevation myocardial infarction from the CRUSADE registry to Medicare claims data for follow-up. One-year survival estimates were compared by age group-65-79, 80-84, 85-89, and ≥90 years-and Cox models were used to analyze the association between age and 1-year mortality. RESULTS: Death at 1 year increased markedly with age (from 13.3% for 65-79 years to 45.5% for ≥90 years). In contrast, rehospitalization rates at 1 year were similar and high across ages (65-79 years, 52.7%; ≥90 years, 56.5%), with nearly as many noncardiovascular-related as cardiovascular-related rehospitalizations. At 1 year, nonagenarians had substantially higher rates of death with or without preceding rehospitalization and twice the adjusted mortality than the group aged 65-79 years. CONCLUSIONS: Evolving care delivery models should consider the high mortality in older adults after a non-ST-segment elevation myocardial infarction. Contrary to expectations, rehospitalization rates do not rise substantially with advancing age, and rehospitalization is often for noncardiac diagnoses.
BACKGROUND: Age is associated with outcomes in non-ST-segment elevation myocardial infarction; however, less is known about rehospitalization or death among elderly survivors. We aimed to evaluate mortality and cause-specific rehospitalization rates in this growing population of older adults with ischemic heart disease. METHODS: We linked 36,711 patients aged ≥65 years who survived an index non-ST-segment elevation myocardial infarction from the CRUSADE registry to Medicare claims data for follow-up. One-year survival estimates were compared by age group-65-79, 80-84, 85-89, and ≥90 years-and Cox models were used to analyze the association between age and 1-year mortality. RESULTS:Death at 1 year increased markedly with age (from 13.3% for 65-79 years to 45.5% for ≥90 years). In contrast, rehospitalization rates at 1 year were similar and high across ages (65-79 years, 52.7%; ≥90 years, 56.5%), with nearly as many noncardiovascular-related as cardiovascular-related rehospitalizations. At 1 year, nonagenarians had substantially higher rates of death with or without preceding rehospitalization and twice the adjusted mortality than the group aged 65-79 years. CONCLUSIONS: Evolving care delivery models should consider the high mortality in older adults after a non-ST-segment elevation myocardial infarction. Contrary to expectations, rehospitalization rates do not rise substantially with advancing age, and rehospitalization is often for noncardiac diagnoses.
Authors: John A Dodson; Alexandra M Hajduk; Mary Geda; Harlan M Krumholz; Terrence E Murphy; Sui Tsang; Mary E Tinetti; Michael G Nanna; Richard McNamara; Thomas M Gill; Sarwat I Chaudhry Journal: Ann Intern Med Date: 2019-12-10 Impact factor: 25.391
Authors: Daniel E Forman; Karen Alexander; Ralph G Brindis; Anne B Curtis; Mathew Maurer; Michael W Rich; Laurence Sperling; Nanette K Wenger Journal: F1000Res Date: 2016-01-28
Authors: Öner Özdoğan; Meral Kayıkçıoğlu; Mustafa Kılıçkap; Cenk Ekmekçi; Murat Küçükukur; Ahmet Arif Yalçın; Mustafa Kemal Erol Journal: Anatol J Cardiol Date: 2022-04 Impact factor: 1.475
Authors: Fernando F Gonçalves; José P Guimarães; Sara C Borges; Pedro S Mateus; José I Moreira Journal: J Geriatr Cardiol Date: 2020-08 Impact factor: 3.327