Acute coronary syndrome in octogenarians: association between percutaneous coronary intervention and long-term mortality

Salim Bary Barywani,1 Shijun Li,1,2 Maria Lindh,1 Josefin Ekelund,1 Max Petzold,3 Per Albertsson,4 Lars H Lund,5,6 Michael LX Fu1 1Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Sahlgrenska University Hospital/Östra Hospital, Gothenburg, Sweden; 2Department of Geriatri...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Barywani SB, Li SJ, Lindh M, Ekelund J, Petzold M, Albertsson P, Lund LH, Fu MLX
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Percutaneous coronary intervention mortality octogenarians acute coronary syndrome. Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/3210401933094476b56900b3af21440d
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:3210401933094476b56900b3af21440d
record_format	dspace
spelling	oai:doaj.org-article:3210401933094476b56900b3af21440d2021-12-02T06:34:42ZAcute coronary syndrome in octogenarians: association between percutaneous coronary intervention and long-term mortality1178-1998https://doaj.org/article/3210401933094476b56900b3af21440d2015-09-01T00:00:00Zhttps://www.dovepress.com/acute-coronary-syndrome-in-octogenarians-association-between-percutane-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Salim Bary Barywani,1 Shijun Li,1,2 Maria Lindh,1 Josefin Ekelund,1 Max Petzold,3 Per Albertsson,4 Lars H Lund,5,6 Michael LX Fu1 1Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Sahlgrenska University Hospital/Östra Hospital, Gothenburg, Sweden; 2Department of Geriatrical Cardiology, PLA General Hospitals, Beijing, People’s Republic of China; 3Centre for Applied Biostatistics, University of Gothenurg, Gothenburg, 4Department of Cardiology, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, 5Department of Medicine, Karolinska Institute, 6Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden Aim: Evidence of improved survival after use of percutaneous coronary intervention (PCI) in elderly patients with acute coronary syndrome (ACS) is limited. We assessed the association between PCI and long-term mortality in octogenarians with ACS. Methods and results: We followed 353 consecutive patients aged ≥80 years hospitalized with ACS during 2006–2007. Among them, 182 were treated with PCI, whereas 171 were not. PCI-treated patients were younger and more often male, and had less stroke and dependency in activities of daily living, but there were no significant differences in occurrence of diabetes mellitus, chronic obstructive pulmonary disease, hypertension, and uncured malignancies between the two groups. The association between PCI and all-cause mortality was assessed in the overall cohort and a 1:1 matched cohort based on propensity score (PS). In overall cohort, 5-year all-cause mortality was 46.2% and 89.5% in the PCI and non-PCI groups, respectively. Cox regression analysis in overall cohort by adjustment for ten baseline variables showed statistically significant association between PCI and reduced long-term mortality (P<0.001, hazard ratio 0.4, 95% confidence interval [CI] 0.2–0.5). In propensity-matched cohort, 5-year all-cause mortality was 54.9% and 83.1% in the PCI and non-PCI groups, respectively. Kaplan–Meier survival curves and log rank test showed significantly improved mean survival rates (P=0.001): 48 months (95% CI 41–54) for PCI-treated patients versus 35 months (95% CI 29–42) for non-PCI-treated patients. Furthermore, by performing Cox regression analysis, PCI was still associated with reduced long-term mortality (P=0.029, hazard ratio 0.5, 95% CI 0.3–0.9) after adjustment for PS and confounders: age, male sex, cognitive deterioration, uncured malignancies, left ventricular ejection fraction ≤45%, estimated glomerular filtration rate ≤35 mL/min, ST-segment elevation myocardial infarction, mitral regurgitation, and medication at discharge with clopidogrel and statins. Conclusion: In octogenarians with ACS, PCI was associated with improved survival from all-cause death over 5 years of follow-up. Keywords: percutaneous coronary intervention, mortality, octogenarians, acute coronary syndromeBarywani SBLi SJLindh MEkelund JPetzold MAlbertsson PLund LHFu MLXDove Medical PressarticlePercutaneous coronary interventionmortalityoctogenariansacute coronary syndrome.GeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 10, Pp 1547-1553 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Percutaneous coronary intervention mortality octogenarians acute coronary syndrome. Geriatrics RC952-954.6
spellingShingle	Percutaneous coronary intervention mortality octogenarians acute coronary syndrome. Geriatrics RC952-954.6 Barywani SB Li SJ Lindh M Ekelund J Petzold M Albertsson P Lund LH Fu MLX Acute coronary syndrome in octogenarians: association between percutaneous coronary intervention and long-term mortality
description	Salim Bary Barywani,1 Shijun Li,1,2 Maria Lindh,1 Josefin Ekelund,1 Max Petzold,3 Per Albertsson,4 Lars H Lund,5,6 Michael LX Fu1 1Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Sahlgrenska University Hospital/Östra Hospital, Gothenburg, Sweden; 2Department of Geriatrical Cardiology, PLA General Hospitals, Beijing, People’s Republic of China; 3Centre for Applied Biostatistics, University of Gothenurg, Gothenburg, 4Department of Cardiology, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, 5Department of Medicine, Karolinska Institute, 6Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden Aim: Evidence of improved survival after use of percutaneous coronary intervention (PCI) in elderly patients with acute coronary syndrome (ACS) is limited. We assessed the association between PCI and long-term mortality in octogenarians with ACS. Methods and results: We followed 353 consecutive patients aged ≥80 years hospitalized with ACS during 2006–2007. Among them, 182 were treated with PCI, whereas 171 were not. PCI-treated patients were younger and more often male, and had less stroke and dependency in activities of daily living, but there were no significant differences in occurrence of diabetes mellitus, chronic obstructive pulmonary disease, hypertension, and uncured malignancies between the two groups. The association between PCI and all-cause mortality was assessed in the overall cohort and a 1:1 matched cohort based on propensity score (PS). In overall cohort, 5-year all-cause mortality was 46.2% and 89.5% in the PCI and non-PCI groups, respectively. Cox regression analysis in overall cohort by adjustment for ten baseline variables showed statistically significant association between PCI and reduced long-term mortality (P<0.001, hazard ratio 0.4, 95% confidence interval [CI] 0.2–0.5). In propensity-matched cohort, 5-year all-cause mortality was 54.9% and 83.1% in the PCI and non-PCI groups, respectively. Kaplan–Meier survival curves and log rank test showed significantly improved mean survival rates (P=0.001): 48 months (95% CI 41–54) for PCI-treated patients versus 35 months (95% CI 29–42) for non-PCI-treated patients. Furthermore, by performing Cox regression analysis, PCI was still associated with reduced long-term mortality (P=0.029, hazard ratio 0.5, 95% CI 0.3–0.9) after adjustment for PS and confounders: age, male sex, cognitive deterioration, uncured malignancies, left ventricular ejection fraction ≤45%, estimated glomerular filtration rate ≤35 mL/min, ST-segment elevation myocardial infarction, mitral regurgitation, and medication at discharge with clopidogrel and statins. Conclusion: In octogenarians with ACS, PCI was associated with improved survival from all-cause death over 5 years of follow-up. Keywords: percutaneous coronary intervention, mortality, octogenarians, acute coronary syndrome
format	article
author	Barywani SB Li SJ Lindh M Ekelund J Petzold M Albertsson P Lund LH Fu MLX
author_facet	Barywani SB Li SJ Lindh M Ekelund J Petzold M Albertsson P Lund LH Fu MLX
author_sort	Barywani SB
title	Acute coronary syndrome in octogenarians: association between percutaneous coronary intervention and long-term mortality
title_short	Acute coronary syndrome in octogenarians: association between percutaneous coronary intervention and long-term mortality
title_full	Acute coronary syndrome in octogenarians: association between percutaneous coronary intervention and long-term mortality
title_fullStr	Acute coronary syndrome in octogenarians: association between percutaneous coronary intervention and long-term mortality
title_full_unstemmed	Acute coronary syndrome in octogenarians: association between percutaneous coronary intervention and long-term mortality
title_sort	acute coronary syndrome in octogenarians: association between percutaneous coronary intervention and long-term mortality
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/3210401933094476b56900b3af21440d
work_keys_str_mv	AT barywanisb acutecoronarysyndromeinoctogenariansassociationbetweenpercutaneouscoronaryinterventionandlongtermmortality AT lisj acutecoronarysyndromeinoctogenariansassociationbetweenpercutaneouscoronaryinterventionandlongtermmortality AT lindhm acutecoronarysyndromeinoctogenariansassociationbetweenpercutaneouscoronaryinterventionandlongtermmortality AT ekelundj acutecoronarysyndromeinoctogenariansassociationbetweenpercutaneouscoronaryinterventionandlongtermmortality AT petzoldm acutecoronarysyndromeinoctogenariansassociationbetweenpercutaneouscoronaryinterventionandlongtermmortality AT albertssonp acutecoronarysyndromeinoctogenariansassociationbetweenpercutaneouscoronaryinterventionandlongtermmortality AT lundlh acutecoronarysyndromeinoctogenariansassociationbetweenpercutaneouscoronaryinterventionandlongtermmortality AT fumlx acutecoronarysyndromeinoctogenariansassociationbetweenpercutaneouscoronaryinterventionandlongtermmortality
_version_	1718399804475703296

Acute coronary syndrome in octogenarians: association between percutaneous coronary intervention and long-term mortality

Ejemplares similares