Abstract

Aim. To assess comorbidities in elderly patients with acute coronary syndrome (ACS) and to analyze patient subgroups with different treatment strategies in the Regional Vascular Center (RVC).Material and methods. The prospective study included 205 patients with confirmed ACS 75 years and older, the mean age was 81±4.9 years, and 68% were women. ST segment elevation myocardial infarction (STEMI) was diagnosed in 46 (22.4 %) patients, non-ST segment elevation myocardial infarction (NSTEMI) was diagnosed in 159 (77,6 %) patients. The Charlson Comorbidity Index (CCI) was calculated in every patient. Early outcomes were defined as those assessed during hospital stay. Late outcomes were assessed at 6 months after the discharge using phone calls and/or clinic visits. All patients provided written informed consent.Results. Percutaneous coronary intervention (PCI) was performed in 42% of patients. In patients with STEMI and NSTEMI PCI was performed in 73% and 32%, respectively. Mean CCI score was 7.9 points: 7.6 points in men and 8.04 in women. Patients with STEMI had higher CCI score than NSTEMI patients (p<0.01): 8.1 points and 7.1 points, respectively. Patients who underwent PCI had lower CCI score (7.2 points) than patients in non-PCI group (8.2 points; p<0.05). Patients with STEMI in PCI and non-PCI groups had significant difference in CCI score (p<0.05): 7.4 and 8.4 points, respectively. Mean CCI score in patients who died in hospital was 8.5 while discharged patients had 7.6 points (p<0.01). In 6 months 13 patients (6.3%) died, their mean age was 84.9 years, mean CCI was 9 points, PCI was performed in 3 (23%) patients.Conclusions. Elderly patients with ACS had high comorbidity level assessed by CCI score. Higher CCI score was associated with PCI non-performance in elderly patients. Elderly patients with STEMI had higher CCI score than patients with NSTEMI which was significantly associated with PCI non-performance. Patients who died in hospital or in 6 months after the ACS onset had higher CCI score than other elderly patients with ACS.

Highlights

  • Mean Charlson Comorbidity Index (CCI) score in patients who died in hospital was 8.5 while discharged patients had 7.6 points (p

  • Patients with segment elevation myocardial infarction (STEMI) had higher CCI score than patients with non-ST segment elevation myocardial infarction (NSTEMI) which was significantly associated with Percutaneous coronary intervention (PCI) non-performance

  • Higher CCI score was associated with PCI non-performance in elderly patients

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Summary

КЛИНИЧЕСКИЙ ОПЫТ

Гиляров М.Ю.1,2,3, Константинова Е.В.1,2*, Атабегашвили М.Р.1, Солнцева Т.Д.4, Аничков Д.А.2, Костина А.Н.3, Полибин Р.В.3, Удовиченко А.Е.1,2,3, Свет А.В.1,3. Через 6 мес от начала заболевания умерли 13 пациентов (6,3%), их средний возраст составил 84,9 лет, среднее значение CCI в данной группе было 9 баллов, ЧКВ было выполнено у 3 (23%) пациентов. Пациенты старческого возраста с ОКСбпST имеют большее значение CCI в сравнении с пациентами с ОКСпST, что значимо коррелирует с невыполнением им ЧКВ. Higher CCI score was associated with PCI non-performance in elderly patients. Patients with STEMI had higher CCI score than patients with NSTEMI which was significantly associated with PCI non-performance. Цель настоящего исследования: изучить выраженность коморбидных состояний у пациентов старческого возраста с ОКС и провести анализ подгрупп, выделенных в зависимости от стратегии ведения пациентов, в повседневной работе регионального сосудистого центра (РСЦ)

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