Comparison of Outcomes of Acute Coronary Syndrome in Patients >= 80 Years Versus Those < 80 Years in Israel from 2000 to 2013

作者：Shechter Michael^*; Rubinstein Roy; Goldenberg Ilan; Matetzki Shlomi

来源：American Journal of Cardiology, 2017, 120(8): 1230-1237.

DOI：10.1016/j.amjcard.2017.07.003

Although patients >= 80 years old constitute the fastest-growing segment of the population and have a high prevalence of coronary artery disease, few data exist regarding the outcome of octogenarians with acute coronary syndrome (ACS). In a retrospective study based on data of 13,432 ACS patients who were enrolled in the ACS Israel Survey, we first evaluated the, clinical outcome of 1,731 ACS patients >= 80 years (13%) compared with 11,701 ACS patients <80 years (87%) hospitalized during 2000 to 2013. Second, we evaluated the clinical outcome of patients years hospitalized during the 2000 to 2006 ("early") period (n = 1,037) compared with those of the same age group of patients hospitalized during the 2008 to 2013 ("late") period (n = 694). Implementation of the ACS AHA/ACC/ESC therapeutic guidelines was lower in ACS patients years compared with patients <80 years. Multivariate Cox regression analysis demonstrated a worse 1-year survival rate in the ACS patients 80 years compared with those <80 years. During the late period, patients years - were more frequently treated with guideline-recommended therapies compared with patients from the same age group who were hospitalized in the early period. Multivariate Cox regression analysis demonstrated a better 1-year survival rate of patients >= 80 years during the late period compared with the early period (hazard ratio 1.17, 95% confidence interval 1.15 to 1.61; p = 0.01). In addition, adverse outcome rates of ACS patients >= 80 years were significantly higher compared with those of patients <80 years. However, survival rates of ACS patients years were improved over,the 200 to 2013 period.

• 出版日期2017-10-15