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Clinical Outcomes of Elderly Patients with Non ST-Segment Elevation Myocardial Infarction Undergoing Coronary Artery

Woo Jin Kim1, Myung Ho Jeong2, Dong Goo Kang1

  • 1Department of Cardiology, Kwangju Christian Hospital, Gwangju, Korea.

Chonnam Medical Journal
|February 6, 2018
PubMed

Insights

Elderly patients (≥75 years) with Non-ST-segment elevation myocardial infarction (NSTEMI) undergoing coronary artery bypass grafting (CABG) had higher in-hospital mortality. However, long-term adverse cardiovascular events were similar between elderly and non-elderly groups.

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Cardiovascular Surgery

Background:

  • Non-ST-segment elevation myocardial infarction (NSTEMI) is a common cardiac emergency.
  • Coronary artery bypass grafting (CABG) is a treatment option for NSTEMI patients.
  • The clinical outcomes of elderly patients undergoing CABG for NSTEMI require further investigation.

Purpose of the Study:

  • To compare the clinical outcomes of elderly (≥75 years) versus non-elderly (<75 years) patients with NSTEMI who underwent CABG.
  • To identify predictors of in-hospital mortality in NSTEMI patients undergoing CABG.

Main Methods:

  • Retrospective analysis of 451 NSTEMI patients who underwent CABG, registered in the Korea Acute Myocardial Infarction Registry (2003-2012).
  • Patients were divided into elderly (≥75 years, n=124) and non-elderly (<75 years, n=327) groups.
  • One-year follow-up data was collected to assess major adverse cardiovascular events (MACE).

Main Results:

  • In-hospital mortality was significantly higher in the elderly group (11.3%) compared to the non-elderly group (4.9%, p=0.015).
  • No significant differences were observed in one-year cardiac death, myocardial infarction, or MACE between the two groups.
  • Left ventricular (LV) dysfunction (ejection fraction ≤40%) and older age were predictors of in-hospital mortality.

Conclusions:

  • Elderly NSTEMI patients may be suitable candidates for CABG, but careful surgical consideration is warranted.
  • The presence of severe LV systolic dysfunction in elderly NSTEMI patients necessitates cautious evaluation before CABG.
  • While in-hospital mortality is higher in the elderly, long-term outcomes after CABG are comparable to younger patients.

Keywords:
AgedCoronary Artery BypassMyocardial Infaction

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