Predictors of in-hospital mortality in very eldery patients presenting with acute coronary syndrome: A single-center study
Objective: Acute coronary syndrome (ACS) has become more frequent in the elderly population due to increased life expectancy. The aim of this trial was to determine clinical and laboratory factors related to in-hospital mortality in patients over 80 years of age who presented with ACS. Methods: A to...
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| Format: | Article |
| Language: | English |
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KARE Publishing
2019-01-01
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| Series: | Türk Kardiyoloji Derneği Arşivi |
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| Online Access: | https://jag.journalagent.com/z4/download_fulltext.asp?pdir=tkd&un=TKDA-68792 |
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| author | Samet Yılmaz Mehmet Koray Adalı Oğuz Kılıç Ayşen Til Yalın Tolga Yaylalı Dursun Dursunoğlu Havane Asuman Kaftan |
| author_facet | Samet Yılmaz Mehmet Koray Adalı Oğuz Kılıç Ayşen Til Yalın Tolga Yaylalı Dursun Dursunoğlu Havane Asuman Kaftan |
| author_sort | Samet Yılmaz |
| collection | DOAJ |
| description | Objective: Acute coronary syndrome (ACS) has become more frequent in the elderly population due to increased life expectancy. The aim of this trial was to determine clinical and laboratory factors related to in-hospital mortality in patients over 80 years of age who presented with ACS.
Methods: A total 171 patients (86 men, median age 83 years) who were over 80 years of age and were hospitalized due to a diagnosis of ACS were enrolled in this study. The patients' demographic data, clinical features, and laboratory values were screened retrospectively from hospital records.
Results: During the follow-up period, 19 of 171 patients (11.1%) died. The causes of death were cardiogenic shock (n=6, 31.5%), acute renal failure (n=6, 31.5%), arrhythmia (n=4, 21%), and septic shock (n=3, 15.7%). ST-segment elevation myocardial infarction presentation was more common among those who died [14 (73.7%) vs. 31 (20.5%); p<0.001]. Patients who died during in-hospital follow-up also had higher peak troponin [3.1 ng/mL (7.2) vs. 0.3 ng/mL (1.6); p<0.001] and creatine kinase-MB levels [96.7 ng/mL (194) vs. 10.9 ng/mL (36.2); p<0.001]. The results indicated that a high Global Registry of Acute Coronary Events (GRACE) risk score [odds risk (OR): 1.074, 95% confidence interval (CI): 1.039–1.110; p<0.001], ejection fraction (EF) ≤40% (OR: 8.113, 95% CI: 1.101–59.773; p=0.040), or no use of an angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB) (OR: 0.075, 95% CI: 0.006–0.995; p=0.049) was significantly associated with in-hospital mortality.
Conclusion: Presentation with a high GRACE risk score, no use of an ACEI/ARB, and a low EF at admission were associated with in-hospital mortality in ACS patients more than 80 years old. |
| first_indexed | 2024-04-10T14:06:22Z |
| format | Article |
| id | doaj.art-43b5b2da1adb471facd77656ee948442 |
| institution | Directory Open Access Journal |
| issn | 1016-5169 |
| language | English |
| last_indexed | 2024-04-10T14:06:22Z |
| publishDate | 2019-01-01 |
| publisher | KARE Publishing |
| record_format | Article |
| series | Türk Kardiyoloji Derneği Arşivi |
| spelling | doaj.art-43b5b2da1adb471facd77656ee9484422023-02-15T16:09:56ZengKARE PublishingTürk Kardiyoloji Derneği Arşivi1016-51692019-01-01471384410.5543/tkda.2018.68792TKDA-68792Predictors of in-hospital mortality in very eldery patients presenting with acute coronary syndrome: A single-center studySamet Yılmaz0Mehmet Koray Adalı1Oğuz Kılıç2Ayşen Til3Yalın Tolga Yaylalı4Dursun Dursunoğlu5Havane Asuman Kaftan6Department of Cardiology, Pamukkale University Hospitals, Denizli, TurkeyDepartment of Cardiology, Pamukkale University Hospitals, Denizli, TurkeyDepartment of Cardiology, Pamukkale University Hospitals, Denizli, TurkeyDepartment of Public Health, Pamukkale University Faculty of Medicine, Denizli, TurkeyDepartment of Cardiology, Pamukkale University Hospitals, Denizli, TurkeyDepartment of Cardiology, Pamukkale University Hospitals, Denizli, TurkeyDepartment of Cardiology, Pamukkale University Hospitals, Denizli, TurkeyObjective: Acute coronary syndrome (ACS) has become more frequent in the elderly population due to increased life expectancy. The aim of this trial was to determine clinical and laboratory factors related to in-hospital mortality in patients over 80 years of age who presented with ACS. Methods: A total 171 patients (86 men, median age 83 years) who were over 80 years of age and were hospitalized due to a diagnosis of ACS were enrolled in this study. The patients' demographic data, clinical features, and laboratory values were screened retrospectively from hospital records. Results: During the follow-up period, 19 of 171 patients (11.1%) died. The causes of death were cardiogenic shock (n=6, 31.5%), acute renal failure (n=6, 31.5%), arrhythmia (n=4, 21%), and septic shock (n=3, 15.7%). ST-segment elevation myocardial infarction presentation was more common among those who died [14 (73.7%) vs. 31 (20.5%); p<0.001]. Patients who died during in-hospital follow-up also had higher peak troponin [3.1 ng/mL (7.2) vs. 0.3 ng/mL (1.6); p<0.001] and creatine kinase-MB levels [96.7 ng/mL (194) vs. 10.9 ng/mL (36.2); p<0.001]. The results indicated that a high Global Registry of Acute Coronary Events (GRACE) risk score [odds risk (OR): 1.074, 95% confidence interval (CI): 1.039–1.110; p<0.001], ejection fraction (EF) ≤40% (OR: 8.113, 95% CI: 1.101–59.773; p=0.040), or no use of an angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB) (OR: 0.075, 95% CI: 0.006–0.995; p=0.049) was significantly associated with in-hospital mortality. Conclusion: Presentation with a high GRACE risk score, no use of an ACEI/ARB, and a low EF at admission were associated with in-hospital mortality in ACS patients more than 80 years old.https://jag.journalagent.com/z4/download_fulltext.asp?pdir=tkd&un=TKDA-68792acute coronary syndromeelderly; mortality. |
| spellingShingle | Samet Yılmaz Mehmet Koray Adalı Oğuz Kılıç Ayşen Til Yalın Tolga Yaylalı Dursun Dursunoğlu Havane Asuman Kaftan Predictors of in-hospital mortality in very eldery patients presenting with acute coronary syndrome: A single-center study Türk Kardiyoloji Derneği Arşivi acute coronary syndrome elderly; mortality. |
| title | Predictors of in-hospital mortality in very eldery patients presenting with acute coronary syndrome: A single-center study |
| title_full | Predictors of in-hospital mortality in very eldery patients presenting with acute coronary syndrome: A single-center study |
| title_fullStr | Predictors of in-hospital mortality in very eldery patients presenting with acute coronary syndrome: A single-center study |
| title_full_unstemmed | Predictors of in-hospital mortality in very eldery patients presenting with acute coronary syndrome: A single-center study |
| title_short | Predictors of in-hospital mortality in very eldery patients presenting with acute coronary syndrome: A single-center study |
| title_sort | predictors of in hospital mortality in very eldery patients presenting with acute coronary syndrome a single center study |
| topic | acute coronary syndrome elderly; mortality. |
| url | https://jag.journalagent.com/z4/download_fulltext.asp?pdir=tkd&un=TKDA-68792 |
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