Photo Credit: Mr. Suphachai Praserdumrongchai
The following is a summary of “Patients aged 90 years and above with acute coronary syndrome in the cardiac intensive care unit: management and outcomes,” published in the March 2024 issue of Cardiology by Sarma et al.
Limited data exist regarding outcomes after coronary angiography (CAG) and percutaneous coronary intervention (PCI) in patients aged ≥90 years admitted to the cardiac intensive care unit (CICU) with acute coronary syndrome (ACS).
Researchers conducted a retrospective study evaluating the CAG and PCI patient population’s in-hospital and 1-year mortality rates to assess the impact of different therapeutic approaches.
They studied CICU patients ≥90 years with ACS(2007 to 2018) and examined three therapeutic approaches, no CAG, CAG/no PCI, and CAG/PCI. Logistic regression was used to assess. In-hospital mortality and 1-year mortality were assessed using Cox proportional hazards analysis. Patient characteristics were analyzed for mortality association.
The results included 239 patients (57% females, 45% ST-elevation myocardial infarction, 8% cardiac arrest, 16% shock). In-hospital mortality was 20.8% overall and did not differ significantly between the no CAG (n = 103, 21.4%), CAG/no PCI (n = 47, 21.3%), and CAG/PCI (n = 90, 20.0%) groups, pre- or post-adjustment. Similarly, overall 1-year mortality was 52.5%, with no significant difference between the therapeutic groups. Median survival was 6.9 months overall, and 41.2% of hospital survivors died within one year of CICU admission.
Investigators concluded that elderly patients with ACS admitted to the CICU faced high mortality rates, regardless of therapeutic approach, which emphasized the importance of careful patient selection for invasive procedures.
Source: ajconline.org/article/S0002-9149(24)00053-5/abstract#%20