Improved short and long term survival associated with percutaneous coronary intervention in the elderly patients with acute coronary syndrome
Abstract Background Percutaneous coronary intervention (PCI) are increasingly used in daily clinical practice in elderly patients with acute coronary syndrome (ACS) despite limited evidence. The purpose of this study was to assess the impact of PCI on short and long term survivals in a large cohort...
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| Format: | Article |
| Language: | English |
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BMC
2018-06-01
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| Series: | BMC Geriatrics |
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| Online Access: | http://link.springer.com/article/10.1186/s12877-018-0818-z |
| _version_ | 1819178516926693376 |
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| author | Xiaojing Chen Salim Bary Barywani Runa Sigurjonsdottir Michael Fu |
| author_facet | Xiaojing Chen Salim Bary Barywani Runa Sigurjonsdottir Michael Fu |
| author_sort | Xiaojing Chen |
| collection | DOAJ |
| description | Abstract Background Percutaneous coronary intervention (PCI) are increasingly used in daily clinical practice in elderly patients with acute coronary syndrome (ACS) despite limited evidence. The purpose of this study was to assess the impact of PCI on short and long term survivals in a large cohort of elderly patients with ACS from a “real world”. Methods We enrolled 491 patients aged ≥70 years admitted to our institution with ACS from 2006 to 2012. Effect of PCI on short and long term survival was evaluated in both overall and a propensity score-matched cohort. Results The mean age of the overall cohort is 83 ± 6 years. Among them, 285 were treated with PCI, whereas 206 were not. Patients treated with PCI were younger (82 ± 5 vs. 85 ± 6), more males (67% vs. 46%), with lower heart rate (77 ± 22 vs. 84 ± 21), higher eGFR (58 ± 20 vs. 47 ± 23), and less with heart failure (29% vs. 15%) (all p < 0.001). In both overall and propensity-matched population, improved survival was associated with PCI-treatment at 1 and 3 years (p < 0.001 for all comparisons). Furthermore, by using multivariate Cox proportional-hazards regression model following factors were identified as independent predictors of 3-year all-cause mortality: age (HR 1.08, 95% CI 1.00–1.16), heart rate (HR 1.02, 95% CI 1.01–1.03), eGFR (HR 3.07, 95% CI 1.63–5.77), malignancy (HR 2.03, 95% CI 1.27–4.57), prior CABG (HR 2.033, 95% CI 1.27–4.57), medication with statin (HR 0.40, 95% CI 0.19–0.86) in PCI group, whereas age (HR 1.08, 95% CI 1.03–1.13), heart rate (HR 1.01, 95% CI 1.01–1.02), hypertension (HR 1.87, 95% CI 1.01–3.49) and using of ACEI/ARB (HR 0.46, 95% CI 0.28–0.76) in non-PCI group. Conclusions In elderly ACS patients, PCI-treatment was associated with improved 1 and 3-year survival and PCI-treated patients had different prognostic profile compared to those without PCI treatment. |
| first_indexed | 2024-12-22T21:43:48Z |
| format | Article |
| id | doaj.art-34ec70216218400ead8d26d9ce8136ce |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-22T21:43:48Z |
| publishDate | 2018-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-34ec70216218400ead8d26d9ce8136ce2022-12-21T18:11:32ZengBMCBMC Geriatrics1471-23182018-06-011811910.1186/s12877-018-0818-zImproved short and long term survival associated with percutaneous coronary intervention in the elderly patients with acute coronary syndromeXiaojing Chen0Salim Bary Barywani1Runa Sigurjonsdottir2Michael Fu3Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of GothenburgDepartment of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of GothenburgDepartment of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of GothenburgDepartment of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of GothenburgAbstract Background Percutaneous coronary intervention (PCI) are increasingly used in daily clinical practice in elderly patients with acute coronary syndrome (ACS) despite limited evidence. The purpose of this study was to assess the impact of PCI on short and long term survivals in a large cohort of elderly patients with ACS from a “real world”. Methods We enrolled 491 patients aged ≥70 years admitted to our institution with ACS from 2006 to 2012. Effect of PCI on short and long term survival was evaluated in both overall and a propensity score-matched cohort. Results The mean age of the overall cohort is 83 ± 6 years. Among them, 285 were treated with PCI, whereas 206 were not. Patients treated with PCI were younger (82 ± 5 vs. 85 ± 6), more males (67% vs. 46%), with lower heart rate (77 ± 22 vs. 84 ± 21), higher eGFR (58 ± 20 vs. 47 ± 23), and less with heart failure (29% vs. 15%) (all p < 0.001). In both overall and propensity-matched population, improved survival was associated with PCI-treatment at 1 and 3 years (p < 0.001 for all comparisons). Furthermore, by using multivariate Cox proportional-hazards regression model following factors were identified as independent predictors of 3-year all-cause mortality: age (HR 1.08, 95% CI 1.00–1.16), heart rate (HR 1.02, 95% CI 1.01–1.03), eGFR (HR 3.07, 95% CI 1.63–5.77), malignancy (HR 2.03, 95% CI 1.27–4.57), prior CABG (HR 2.033, 95% CI 1.27–4.57), medication with statin (HR 0.40, 95% CI 0.19–0.86) in PCI group, whereas age (HR 1.08, 95% CI 1.03–1.13), heart rate (HR 1.01, 95% CI 1.01–1.02), hypertension (HR 1.87, 95% CI 1.01–3.49) and using of ACEI/ARB (HR 0.46, 95% CI 0.28–0.76) in non-PCI group. Conclusions In elderly ACS patients, PCI-treatment was associated with improved 1 and 3-year survival and PCI-treated patients had different prognostic profile compared to those without PCI treatment.http://link.springer.com/article/10.1186/s12877-018-0818-zAcute coronary syndromePercutaneous coronary interventionElderlyShort and long outcome |
| spellingShingle | Xiaojing Chen Salim Bary Barywani Runa Sigurjonsdottir Michael Fu Improved short and long term survival associated with percutaneous coronary intervention in the elderly patients with acute coronary syndrome BMC Geriatrics Acute coronary syndrome Percutaneous coronary intervention Elderly Short and long outcome |
| title | Improved short and long term survival associated with percutaneous coronary intervention in the elderly patients with acute coronary syndrome |
| title_full | Improved short and long term survival associated with percutaneous coronary intervention in the elderly patients with acute coronary syndrome |
| title_fullStr | Improved short and long term survival associated with percutaneous coronary intervention in the elderly patients with acute coronary syndrome |
| title_full_unstemmed | Improved short and long term survival associated with percutaneous coronary intervention in the elderly patients with acute coronary syndrome |
| title_short | Improved short and long term survival associated with percutaneous coronary intervention in the elderly patients with acute coronary syndrome |
| title_sort | improved short and long term survival associated with percutaneous coronary intervention in the elderly patients with acute coronary syndrome |
| topic | Acute coronary syndrome Percutaneous coronary intervention Elderly Short and long outcome |
| url | http://link.springer.com/article/10.1186/s12877-018-0818-z |
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