Acute coronary syndromes in octogenarians referred for invasive evaluation: treatment profile and outcomes

Abstract

Here we confirm that in-hospital death and MACE rate remain significantly elevated in octogenarians in spite of implementation of modern therapies. However, our real-world registry strongly suggests that early revascularization appears safe and effective in elderly patients. Furthermore, we have identified that systolic blood pressure, creatine kinase, NT-proBNP, and C-reactive protein are strong predictors for outcomes in octogenarians.

Predictors of in‐hospital mortality in octogenarian patients who underwent primary percutaneous coronary intervention after ST segment elevated myocardial infarction

“…Multivessel disease rates were higher in octogenarians in our study group. This finding was in accordance with the previous findings . Multivessel disease in elderly patients was shown to be correlated with higher adverse cardiac events .…”

“…Furthermore, octogenarians were underrepresented in previous publications. Despite having greater benefit from evidence‐based therapies due to having higher risk, octogenarians have insufficient invasive and medical therapy …”

“…Despite having greater benefit from evidence-based therapies due to having higher risk, octogenarians have insufficient invasive and medical therapy. 13,14 So far, several studies were designed to compare reperfusion therapy with conservative therapy in elderly patients. Advances in mortality and morbidity with invasive therapy were clearly shown in this population.…”

“…This finding was in accordance with the previous findings. 14,20 Multivessel disease in elderly patients was shown to be correlated with higher adverse cardiac events. 22 We showed that octogenarians were not treated as intensely as the younger group because of several concerns despite their higher risk for adverse cardiac events.…”

Management of elderly patients with a non-ST-segment-elevation acute coronary syndrome

“…They comprise a rapidly increasing subgroup of patients with an acute coronary syndrome (ACS) of which non-ST-segment-elevation ACS (NSTE-ACS) is the most common form [1]. Compared with younger patients, elderly patients with ACS are at higher risk of both atherothrombotic events and bleeding, due to frailty and comorbidities such as renal failure [2–4].…”