Acute coronary syndrome in octogenarian patients: results from the international registry of acute coronary syndromes in transitional countries (ISACS-TC) registry
Por:
Manfrini, O, Dorobantu, M, Vasiljevic, Z, Kedev, S, Knezevic, B, Milicic, D, Dilic, M, Trninic, D, Daullxhiu, I, Gustiene, O, Ricci, B, Martelli, I, Cenko, E, Koller, A, Badimon, L, Bugiardini, R
Publicada:
1 ene 2014
Resumen:
We sought to investigate characteristics, treatment, and outcome of octogenarian patients during hospital stay for acute coronary syndrome (ACS) in a transitional country. This is a cohort study of 437 patients >= 80 years old, consecutively admitted with a diagnosis of ACS at 14 hospitals in 8 Eastern European countries reporting data to ISACS-TC registry. The primary endpoint was in-hospital mortality. The mean age of the study population was 83.5 years; 50.1% of the patients were women. Females, less frequently than males, had a history of myocardial infarction, smoking habit, and episodes of typical chest pain. But they were more often admitted with left ventricular dysfunction. The rate of reperfusion treatment (29.5%) was very low in patients with ST-elevation myocardial infarction (STEMI). Also, most of the overall study population had a non-invasive approach (women, 79% vs. men, 70.6%; P = 0.042). However, when the coronary anatomy was known, there were no differences in the rates of revascularization between genders. There was no difference in the rates of death between male (21%) and female (21.1%) patients. Univariate and multivariate analyses revealed that the independent predictors (P < 0.05) of death in octogenarians were systolic blood pressure <100 mmHg (odds ratio [OR], 2.74), Killip class >= 2 (OR, 1.71), and STEMI as an index event (OR, 2.01). Evidence-based drugs (beta-blockers, statins, and ACE-inhibitors) had all independent significant protective effect on the hospital outcome. In conclusion, age is relevant in the prognosis of ACS, but its importance should be considered not secondary to other clinical factors.
Filiaciones:
Manfrini, O:
Univ Bologna, Cardiol Sect, Dept Expt Diagnost & Specialized Med, Bologna, Italy
Dorobantu, M:
Univ Med & Pharm Carol Davila, Dept Cardiol, Clin Emergency Hosp Bucharest, Bucharest, Romania
Vasiljevic, Z:
Univ Belgrade, Clin Ctr Serbia, Belgrade, Serbia
Kedev, S:
Univ Ss Cyril & Methodius, Univ Clin Cardiol, Skopje, Macedonia
Knezevic, B:
Clin Ctr Montenegro, Ctr Cardiol, Podgorica, Montenegro
Milicic, D:
Univ Zagreb, Sch Med, Dept Cardiovasc Dis, Univ Hosp Ctr Zagreb, Zagreb 41000, Croatia
Dilic, M:
Univ Sarajevo, Ctr Clin, Sarajevo 71000, Bosnia & Herceg
Trninic, D:
Clin Ctr Banja Luka, Banja Luka, Republika Srpsk, Bosnia & Herceg
Daullxhiu, I:
Univ Clin Ctr Kosovo, Dept Cardiol, Prishtina, Kosovo
Gustiene, O:
Lithuanian Univ Hlth Sci, Dept Cardiol, Kaunas, Lithuania
Ricci, B:
Univ Bologna, Cardiol Sect, Dept Expt Diagnost & Specialized Med, Bologna, Italy
Martelli, I:
Univ Bologna, Cardiol Sect, Dept Expt Diagnost & Specialized Med, Bologna, Italy
Cenko, E:
Univ Bologna, Cardiol Sect, Dept Expt Diagnost & Specialized Med, Bologna, Italy
Koller, A:
Univ Pecs, Dept Pathophysiol & Gerontol, Pecs, Hungary
Univ Pecs, Szentagothai Res Ctr, Pecs, Hungary
Badimon, L:
Autonomous Univ Barcelona, CiberObn Inst Carlos 3, Hosp Santa Creu & St Pau, Cardiovasc Res Ctr,CSIC ICCC, Barcelona, Spain
Bugiardini, R:
Univ Bologna, Cardiol Sect, Dept Expt Diagnost & Specialized Med, Bologna, Italy
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