RT Journal Article
SR Electronic
T1 In-hospital mortality of acute coronary syndrome in elderly patients
JF Saudi Medical Journal
JO Saudi Med J
FD Prince Sultan Military Medical City
SP 1003
OP 1007
DO 10.15537/smj.2019.10.24583
VO 40
IS 10
A1 Omima E. Ahmed
A1 Samah I. Abohamr
A1 Shaima A. Alharbi
A1 Dawood A. Aldrewesh
A1 Abdulaziz S. Allihimy
A1 Sarah A. Alkuraydis
A1 Ibtihal M. Alhammad
A1 Eman Elsheikh
A1 Ahmad S. Azazy
A1 Asim A. Mohammed
A1 Mehboob A. Dar
A1 Rami M. Abazid
YR 2019
UL http://smj.org.sa/content/40/10/1003.abstract
AB Objectives: To analyze predictors of death in elderly patients diagnosed with acute coronary syndrome (ACS).Methods: A record-based study carried out between January 2016 and January 2018 at The central province in Saudi Arabia. All elderly patients (>75 years) with definite diagnosis of ACS were retrospectively included. Demographic data, echocardiographic, and angiographic parameters were reported.Results: A total of 179 patients were enrolled, 129 (72%) were male. The mean age was 79±4.7 years. Approximately 102 (57%) patients were diagnosed with ST-segment elevation myocardial infarction (STEMI). Of all 125 (70%) underwent invasive coronary angiography, we found that 43 (24%) had significant single vessel disease (1VD), 29 (16.2%) had 2 vessel disease (2VD), and 41 (22.9%) had 3 vessel disease (3VD) or left main stenosis. During hospitalization 21 (11.7%) patients died, t-test analysis showed patients who died were significantly older (82±6.7 versus [vs.] 79±4.2 years, p=0.003). In addition we found that ejection fraction was lower in death group (30.2%±10.7) vs. (36.5%±1.1) in survivors, p=0.017); STEMI was more common in death group (90.5%) vs. (52.5%) in survivors, p=0.001); similarly, the prevalence of 3VD was higher in death group (38.1%) vs. (20.9%) in survivors, p=0.018). Importantly, PCI was not significantly different between death and survival groups (40% vs. 53.8%, p=0.177). A multivariate regression analysis demonstrated that predictors of death were: age (hazard ratio [HR], 1.214; 95% confidence interval [CI], 1.122-1.384; p<0.0001), intubation (HR, 10.106; 95% CI, 9.844-10.792; p<0.0001), and raised creatinine kinase-MB (CK-MB) (HR, 1.005; 95% CI, 1.002-1.013; p=0.04) predicted in hospital death.Conclusion: Older age, mechanical ventilation and raised CK-MB can significantly predict death in elderly patients (>75-year-old) diagnosed with ACS; nevertheless, PCI showed no survival benefits.