Trends in management and outcome of acute coronary syndrome in women ≥80 years versus those <80 years in Israel from 2000-2016.
Acute coronary syndrome
Octogenarians
Outcomes
Recommended treatment guidelines
Women
Journal
International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291
Informations de publication
Date de publication:
15 Apr 2019
15 Apr 2019
Historique:
received:
27
11
2018
revised:
15
01
2019
accepted:
21
01
2019
pubmed:
3
2
2019
medline:
25
12
2019
entrez:
3
2
2019
Statut:
ppublish
Résumé
While women ≥80 years old have a high prevalence of coronary artery disease (CAD), little data exist regarding their outcome following acute coronary syndrome (ACS). In a retrospective study based on data of 3518 ACS women patients who were enrolled in the ACS Israel Survey (ACSIS), we first evaluated and compared the clinical outcomes of 858 ACS women ≥80 years with 2660 ACS women <80 years, hospitalized during 2000-2016. Secondly, we evaluated the clinical outcome of 450 women ≥80 years hospitalized during 2000-2006 ('early period') and compared them with 408 ACS women of the same age group hospitalized during 2008-2016 ('late period'). Implementation of the ACS AHA/ACC/ESC therapeutic guidelines was lower in ACS women ≥80 years compared with women <80 years. Multivariate Cox regression analysis demonstrated a worse 1-year survival rate in the ACS women ≥80 years compared with those <80 years. During the late period women ≥80 years were treated more frequently with guideline-recommended therapies compared with patients from the same age group who were hospitalized in the early period. A significant decline in in-hospital mortality rates in ACS women ≥80 years hospitalized in the late compared with the early period was demonstrated. However, 7-day, 30-day and 1-year mortality rates were not significantly changed. Adverse outcome rates of ACS women ≥80 years were significantly higher compared with those <80 years. In-hospital survival rates of ACS women patients ≥80 years improved during the 2000-2016 period; however, long-term survival rates were not significantly changed.
Sections du résumé
BACKGROUND
BACKGROUND
While women ≥80 years old have a high prevalence of coronary artery disease (CAD), little data exist regarding their outcome following acute coronary syndrome (ACS).
METHODS
METHODS
In a retrospective study based on data of 3518 ACS women patients who were enrolled in the ACS Israel Survey (ACSIS), we first evaluated and compared the clinical outcomes of 858 ACS women ≥80 years with 2660 ACS women <80 years, hospitalized during 2000-2016. Secondly, we evaluated the clinical outcome of 450 women ≥80 years hospitalized during 2000-2006 ('early period') and compared them with 408 ACS women of the same age group hospitalized during 2008-2016 ('late period').
RESULTS
RESULTS
Implementation of the ACS AHA/ACC/ESC therapeutic guidelines was lower in ACS women ≥80 years compared with women <80 years. Multivariate Cox regression analysis demonstrated a worse 1-year survival rate in the ACS women ≥80 years compared with those <80 years. During the late period women ≥80 years were treated more frequently with guideline-recommended therapies compared with patients from the same age group who were hospitalized in the early period. A significant decline in in-hospital mortality rates in ACS women ≥80 years hospitalized in the late compared with the early period was demonstrated. However, 7-day, 30-day and 1-year mortality rates were not significantly changed.
CONCLUSION
CONCLUSIONS
Adverse outcome rates of ACS women ≥80 years were significantly higher compared with those <80 years. In-hospital survival rates of ACS women patients ≥80 years improved during the 2000-2016 period; however, long-term survival rates were not significantly changed.
Identifiants
pubmed: 30709558
pii: S0167-5273(18)36901-8
doi: 10.1016/j.ijcard.2019.01.076
pii:
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
22-27Informations de copyright
Copyright © 2019 Elsevier B.V. All rights reserved.