[Risk factors related to mortality in old patients with coronary heart disease after revascularization]
Xiao-hui Liu1, Jun-ping Kang, Xin DU
1Department of Cardiology, Beijing Anzhen Hospital, Capital University of Medical Sciences, Beijing 100029, China.
Insights
Older patients with coronary heart disease face higher mortality risks post-revascularization if they have anemia or renal insufficiency. Female gender also emerged as an independent risk factor for mortality in this vulnerable population.
Area of Science:
- Cardiology
- Geriatrics
- Nephrology
Context:
- Coronary heart disease (CHD) is a leading cause of mortality in elderly populations.
- Revascularization procedures aim to improve outcomes but carry inherent risks, especially in older adults.
- Identifying specific risk factors for mortality post-revascularization is crucial for targeted interventions.
Purpose:
- To identify and evaluate independent risk factors associated with mortality in elderly patients (age ≥ 70 years) following coronary revascularization.
- To analyze the impact of clinical characteristics, including anemia and renal function, on post-revascularization outcomes.
Summary:
- A study of 675 elderly patients undergoing revascularization found that preexisting anemia (defined by specific hemoglobin levels for males and females), renal insufficiency (serum creatinine > 115 µmol/L), and female gender were significant independent risk factors for mortality.
- Higher creatinine levels (> 177 µmol/L) were associated with a substantially increased hazard rate for mortality.
- Major adverse cardiac and cerebral events (MACCE) were also recorded during the follow-up period.
Impact:
- These findings highlight the importance of assessing and managing anemia and renal insufficiency in elderly CHD patients before and after revascularization.
- The study provides evidence for personalized risk stratification and management strategies in geriatric cardiovascular care.
- Understanding these risk factors can lead to improved patient selection, peri-procedural care, and long-term follow-up protocols.
Objective:
To evaluate the risk factors related to mortality in old patients with coronary heart disease after revascularization.
Methods:
A total of 675 patients (498 males) with age >or= 70 years old who received revascularization during July 2003 to June 2004 and followed up > 30 days after discharge were included in this study. Clinical characteristics, death and major adverse cardiac and cerebral events (MACCE) during follow up were recorded.
Results:
The patients were followed up for a mean period of (754 +/- 355) days. 27 patients (4.0%) died and MACCE developed in 50 patients (7.4%) during follow up. Female and patients with anemia took a significantly higher risk of mortality (RR = 2.750, 95% CI 1.116 - 6.779, P = 0.028, RR = 0.385 95% CI 0.164 - 0.904, P = 0.028, respectively); Creatinine level is positively related to mortality rate. When comparing patients with Cr > 115 micromol/L and Cr > 177 micromol/L with patients with Cr < 115 micromol/L, the hazard rate was 2.963 and 10.785, respectively (95% CI 1.114 - 9.952, P = 0.035 and 95% CI 2.659 - 78.097, P = 0.000) after adjustment for other risk factors.
Conclusion:
Preexisting anaemia (male Hb < 120 g/L, female Hb < 110 g/L), renal insufficiency (Cr > 115 micromol/L) and female gender were found to be independent risk factors for mortality in old patients with coronary heart disease post revascularization.
Related Concept Videos
01:26Coronary Artery Disease IV: Preventive Measures
01:30Coronary Artery Disease I: Introduction
01:27Coronary Artery Disease V: Interprofessional Care
01:30Coronary Artery Disease III: Clinical Manifestations
01:27Heart Failure I: Introduction
01:26Coronary Artery Disease II: Pathophysiology