One-year outcome following coronary angiography in elderly patients with non-ST elevation myocardial infarction: Real-world data from the Acute Coronary Syndromes Israeli Survey (ACSIS)

Jonathan Buber, Ilan Goldenberg, Lizzie Kimron, Victor Guetta

Research output: Contribution to journalReview articlepeer-review

Abstract

OBJECTIVES: We aimed to evaluate the management and outcomes of patients of the octogenarian age group with non-ST elevation myocardial infarction (NSTEMI) in a real-world setting. METHODS: The risk of 30-day and 1-year mortality by age and the time of coronary angiography [categorized as early (≤48 h of admission) and late (>48 h of admission)] was assessed among 2021 NSTEMI patients enrolled in the Acute Coronary Syndrome Israeli Survey (ACSIS) between 2004 and 2008. RESULTS: Elderly patients (≥80 years) comprised almost 20% of the study population, and experienced a significantly higher rate of in-hospital complications. The risk of 1-year mortality was 3.4-fold (P<0.001) higher among octogenarian patients compared with younger patients. Multivariate analysis showed that among patients aged at least 80 years, utilization of revascularization was associated with a lower risk of death at 1 year [hazard ratio (HR)=0.50, P=0.004], but not at 30 days, compared with no angiography. However, referral for early coronary angiography was associated with a lower risk of death both at 30 days and at 1 year (HR=0.4, P=0.04 and HR=0.38, P=0.02, respectively). CONCLUSION: Our findings indicate that patients of the octogenarian age group comprise a high-risk subset of the NSTEMI population, in whom early referral for coronary angiography is independently associated with a lower risk of mortality at 30 days and 1 year.

Original languageEnglish
Pages (from-to)102-109
Number of pages8
JournalCoronary Artery Disease
Volume24
Issue number2
DOIs
StatePublished - Mar 2013

Keywords

  • intervention
  • non-ST elevation myocardial infarction
  • octogenarian patients

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