Short and Long Term Mortality Predictors in Octogenarians with Acute Coronary Syndromes
Halil Atas1, Kursat Tigen, Beste Ozben
1Marmara University School of Medicine Department of Cardiology, Istanbul, Turkey. email@email.com.
Insights
Predictors of mortality in elderly patients with acute coronary syndrome (ACS) include ST-segment-elevation myocardial infarction, hypotension, and impaired cardiac function. Atrial fibrillation and hyponatremia also predict long-term mortality in octogenarians with ACS.
Area of Science:
- Cardiology
- Geriatric Medicine
- Clinical Research
Background:
- Octogenarians experiencing acute coronary syndromes (ACS) face elevated mortality and morbidity.
- Comorbidities and frailty are more prevalent in this age group, complicating ACS management.
Purpose of the Study:
- To identify predictors of both short-term (in-hospital) and long-term (one-year) mortality in octogenarians with ACS.
- To inform clinical attention towards high-risk individuals within this demographic.
Main Methods:
- A cohort of 98 consecutive octogenarians with ACS was studied.
- Patients underwent coronary angiography and received optimal medical treatment.
- Cardiovascular mortality at hospital discharge and at one year were the primary endpoints.
Main Results:
- In-hospital mortality was associated with ST-segment-elevation myocardial infarction, hypotension, and reduced left ventricular ejection fraction.
- Long-term mortality was linked to atrial fibrillation, hyponatremia, and renal dysfunction.
- All deceased patients exhibited lower left ventricular ejection fraction and glomerular filtration rate.
Conclusions:
- ST-segment-elevation myocardial infarction, hypotension, impaired left ventricular function, hyponatremia, atrial fibrillation, and renal dysfunction are key predictors of mortality in octogenarians with ACS.
- These findings highlight specific risk factors that warrant close monitoring and management in elderly ACS patients.
Purpose:
Octogenarians with acute coronary syndromes have higher mortality and morbidity due to higher prevalence of comorbidities and frailty. The aim of this study was to explore the predictors of short and long term mortality in octogenarians with ACS.
Methods:
Ninety-eight consecutive octogenarians presenting with acute coronary syndrome (mean age:84±3 years, 56 male) were included. All patients underwent coronary angiography and were given optimal medical treatment. The primary end point was cardiovascular mortality in hospital and at one year.
Results:
Fifteen patients died during hospitalization and 20 patients died after discharge within the first year. ST-segment-elevation myocardial infarction and hypotension were significantly more prevalent in the in-hospital mortality group while atrial fibrillation and hyponatremia were more prevalent in the long-term mortality group. All deceased patients had significantly lower left ventricular ejection fraction and glomerular filtration rate. Cox analysis revealed ST-segment-elevation myocardial infarction, hypotension and left ventricular ejection fraction as independent predictors of in-hospital mortality while hyponatremia, atrial fibrillation and renal dysfunction as independent predictors of long term mortality.
Conclusion:
It would be reasonable to pay further attention to octogenarians with acute coronary syndrome if they are presenting with ST-segment-elevation myocardial infarction, and have hypotension, impaired left ventricular function, hyponatremia, atrial fibrillation or renal dysfunction, which are associated with increased mortality.
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