Age and outcome after acute coronary syndromes without persistent ST-segment elevation
D Hasdai1, D R Holmes, D A Criger
1Department of Cardiology, Rabin Medical Center, Petah Tikva, Israel.
American Heart Journal
|April 27, 2000
Summary
Age did not impact the effectiveness of eptifibatide in patients with acute coronary syndromes. Older patients experienced worse outcomes, fewer procedures, and poorer baseline health.
Area of Science:
- Cardiology
- Geriatric Medicine
- Pharmacology
Background:
- Age is a significant predictor of mortality in ST-segment elevation myocardial infarction.
- The influence of age on outcomes in non-ST-segment elevation acute coronary syndromes is not well-established.
- The effect of age on the efficacy of antiplatelet therapy, specifically eptifibatide, requires investigation.
Purpose of the Study:
- To evaluate the impact of age on clinical outcomes in patients with acute coronary syndromes without persistent ST-segment elevation.
- To determine if age modifies the efficacy of eptifibatide therapy in this patient population.
Main Methods:
- Analysis of data from the Platelet Glycoprotein IIb/IIIa in Unstable Angina Receptor Suppression Using Integrilin Therapy (PURSUIT) trial.
- Stratification of 9461 patients into 10-year age groups (/=80).
- Assessment of the primary outcome (death or myocardial infarction) at 30 days and 6 months, and examination of treatment interaction with age.
Main Results:
- Eptifibatide demonstrated a significant improvement in 30-day outcomes (P=.04).
- No significant interaction was found between age and eptifibatide treatment efficacy (P=.16).
- Older age groups showed increased rates of death or myocardial infarction at 30 days and 6 months, and lower rates of coronary angiography.
Conclusions:
- Age does not significantly influence the effectiveness of eptifibatide in patients with acute coronary syndromes without persistent ST-segment elevation.
- Older patients present with more severe clinical profiles, undergo fewer invasive procedures, and experience worse outcomes.
- Findings suggest that while older patients have worse prognoses, eptifibatide remains an effective treatment option across age groups.
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