In-hospital Outcome in Octogenarians with Acute Coronary Syndrome Undergoing Emergent Coronary Angiography

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概要

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• Very elderly patients have higher mortality rates than younger patients after acute coronary syndrome (ACS). However, the mechanism by which increasing age contributes to such mortality remains unclear. In addition, the efficacy and safety of invasive coronary procedures for octogenarians with ACS have not been well established. We compared the clinical characteristics and in-hospital outcome of 193 octogenarians (mean age, 83 years) with those of 1,462 younger patients (mean age, 64 years) with ACS who underwent emergent coronary angiography. Octogenarians included a greater number of females, had higher rates of cerebrovascular disease and multivessel disease, a higher Killip class, a higher Forrester class, and lower rates of smoking, diabetes, and hypercholesterolemia than the younger subjects. Interventions, including percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG), were performed less frequently in octogenarians than in younger patients (88.0% versus 90.8%). The procedural success rate in octogenarians did not differ from that in younger patients. However, the in-hospital mortality rate for the octogenarians was about three times higher than for the younger patients (19.2% versus 6.9%). Multivariate analysis revealed that the predictors of in-hospital mortality in the octogenarians were a higher Killip class and a higher Forrester class. Octogenarians with ACS had fewer coronary risk factors and a similar success rate for the intervention, but had more greatly impaired hemodynamics and higher in-hospital mortality than the younger patients. Therefore, impaired myocardial reserve may contribute to a large portion of in-hospital deaths in octogenarians with ACS.

• Japanese Heart Journal Associationの論文

著者

• Terai Hidenobu

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School

• Ino Hidekazu

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School

• Hayashi Kenshi

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School

• Hayashi Tatsumi

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School

• Shimizu Masami

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School

• Yamaguchi Masato

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School

• Sakata Kenji

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School

• Inoue Masaru

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School

• Mabuchi Hiroshi

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School

• Inoue Masaru

  石川県立中央病院 循環器内科

• Ino Hidekazu

  金沢大学 医学系研究科循環器内科

• Kaneda Tomoya

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School

• Kaneda Tomoya

  Molecular Genetics Of Cardiovascular Disorders Division Of Cardiovascular Medicine Graduate School O

• Oe Kotaro

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School

• Kiyama Masaru

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School

• Shimizu Masami

  Molecular Genetics Of Cardiovascular Disorders Division Of Cardiovascular Medicine Graduate School O

• Terai Hidenobu

  Molecular Genetics Of Cardiovascular Disorders Division Of Cardiovascular Medicine Graduate School O

• Hayashi Tatsumi

  Molecular Genetics Of Cardiovascular Disorders Division Of Cardiovascular Medicine Kanazawa Universi

• Oe Kotaro

  Molecular Genetics Of Cardiovascular Disorders Division Of Cardiovascular Medicine Graduate School O

• Mabuchi Hiroshi

  Molecular Genetics Of Cardiovascular Disorders Division Of Cardiovascular Medicine Graduate School O

• Yamaguchi Masato

  Molecular Genetics Of Cardiovascular Disorders Division Of Cardiovascular Medicine Graduate School O

• Kaneda Tomoya

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School of Medical Science, Kanazawa University

• Hayashi Tatsumi

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School of Medical Science, Kanazawa University

• Terai Hidenobu

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School of Medical Science, Kanazawa University

• Yamaguchi Masato

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School of Medical Science, Kanazawa University

• Kiyama Masaru

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School of Medical Science, Kanazawa University

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