Long-term results of invasive and non-invasive treatment strategies in the elderly patients with acute coronary syndrome
The aim – to evaluate long-term outcomes of conservative (optimised medical therapy) versus revascularization strategy of elderly patients with acute coronary syndrome in a real world practice. Materials and methods. Prospective analysis of event-free survival of 113 consecutive patients with acute...
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| Format: | Article |
| Language: | English |
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TOV Chetverta Khvylia
2019-10-01
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| Series: | Кардіохірургія та інтервенційна кардіологія |
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| Online Access: | http://csic.com.ua/images/pdf/2019/3-2019/long-term-results-of-invasive-and-non-invasive-treatment-strategies.pdf |
| _version_ | 1818554340294524928 |
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| author | R.R. Komorovsky |
| author_facet | R.R. Komorovsky |
| author_sort | R.R. Komorovsky |
| collection | DOAJ |
| description | The aim – to evaluate long-term outcomes of conservative (optimised medical therapy) versus revascularization strategy of elderly patients with acute coronary syndrome in a real world practice.
Materials and methods. Prospective analysis of event-free survival of 113 consecutive patients with acute coronary syndrome aged ≥ 70 years. Study end-points: cardiac death, non-fatal myocardial infarction, unstable angina pectoris, re-hospitalisation.
Results. Overall, event-free survival (freedom from death, myocardial infarction, unstable angina or re-hospitalisation) was 59 % at 20 (12–25) months follow-up. The incidence of these events was significantly higher (p = 0.03) in patients receiving only medical therapy compared with those who underwent coronary artery bypass grafting surgery and borderline higher (p = 0.08) compared to percutaneous coronary intervention group patients. The event-free survival rates in both invasively treated groups of patients were not different (p = 0.81). The incidence of soft events, including unstable angina pectoris or re-hospitalisation, was significantly lower in the coronary artery bypass grafting group (р = 0.04) as compared with the medical therapy group, while the incidence of hard events (cardiac death and non-fatal myocardial infarction) was similar in all groups. According to Cox proportional hazard analysis, low ejection fraction (< 40 %) and concomitant peripheral arterial disease were found to be independent predictors of hard events.
Conclusion. Coronary artery bypass grafting in the elderly (aged ≥ 70 years) patients appears to be superior to conservative strategy in terms of event-free survival. |
| first_indexed | 2024-12-12T09:38:06Z |
| format | Article |
| id | doaj.art-cfdf484ad7ff42648e440350b8870ef8 |
| institution | Directory Open Access Journal |
| issn | 2305-3127 |
| language | English |
| last_indexed | 2024-12-12T09:38:06Z |
| publishDate | 2019-10-01 |
| publisher | TOV Chetverta Khvylia |
| record_format | Article |
| series | Кардіохірургія та інтервенційна кардіологія |
| spelling | doaj.art-cfdf484ad7ff42648e440350b8870ef82022-12-22T00:28:40ZengTOV Chetverta KhvyliaКардіохірургія та інтервенційна кардіологія2305-31272019-10-013222910.31928/2305-3127-2019.3.2229Long-term results of invasive and non-invasive treatment strategies in the elderly patients with acute coronary syndromeR.R. Komorovsky0I. Horbachevsky Ternopil National Medical University, Ternopil, UkraineThe aim – to evaluate long-term outcomes of conservative (optimised medical therapy) versus revascularization strategy of elderly patients with acute coronary syndrome in a real world practice. Materials and methods. Prospective analysis of event-free survival of 113 consecutive patients with acute coronary syndrome aged ≥ 70 years. Study end-points: cardiac death, non-fatal myocardial infarction, unstable angina pectoris, re-hospitalisation. Results. Overall, event-free survival (freedom from death, myocardial infarction, unstable angina or re-hospitalisation) was 59 % at 20 (12–25) months follow-up. The incidence of these events was significantly higher (p = 0.03) in patients receiving only medical therapy compared with those who underwent coronary artery bypass grafting surgery and borderline higher (p = 0.08) compared to percutaneous coronary intervention group patients. The event-free survival rates in both invasively treated groups of patients were not different (p = 0.81). The incidence of soft events, including unstable angina pectoris or re-hospitalisation, was significantly lower in the coronary artery bypass grafting group (р = 0.04) as compared with the medical therapy group, while the incidence of hard events (cardiac death and non-fatal myocardial infarction) was similar in all groups. According to Cox proportional hazard analysis, low ejection fraction (< 40 %) and concomitant peripheral arterial disease were found to be independent predictors of hard events. Conclusion. Coronary artery bypass grafting in the elderly (aged ≥ 70 years) patients appears to be superior to conservative strategy in terms of event-free survival.http://csic.com.ua/images/pdf/2019/3-2019/long-term-results-of-invasive-and-non-invasive-treatment-strategies.pdfacute coronary syndromeelderlyoutcomerevascularization |
| spellingShingle | R.R. Komorovsky Long-term results of invasive and non-invasive treatment strategies in the elderly patients with acute coronary syndrome Кардіохірургія та інтервенційна кардіологія acute coronary syndrome elderly outcome revascularization |
| title | Long-term results of invasive and non-invasive treatment strategies in the elderly patients with acute coronary syndrome |
| title_full | Long-term results of invasive and non-invasive treatment strategies in the elderly patients with acute coronary syndrome |
| title_fullStr | Long-term results of invasive and non-invasive treatment strategies in the elderly patients with acute coronary syndrome |
| title_full_unstemmed | Long-term results of invasive and non-invasive treatment strategies in the elderly patients with acute coronary syndrome |
| title_short | Long-term results of invasive and non-invasive treatment strategies in the elderly patients with acute coronary syndrome |
| title_sort | long term results of invasive and non invasive treatment strategies in the elderly patients with acute coronary syndrome |
| topic | acute coronary syndrome elderly outcome revascularization |
| url | http://csic.com.ua/images/pdf/2019/3-2019/long-term-results-of-invasive-and-non-invasive-treatment-strategies.pdf |
| work_keys_str_mv | AT rrkomorovsky longtermresultsofinvasiveandnoninvasivetreatmentstrategiesintheelderlypatientswithacutecoronarysyndrome |