Abstract
BackgroundIncreased life expectancy across the world has resulted in an increase in the proportion of the elderly population who are lost to heart diseases. Advanced age and comorbidities are believed to change the response to treatments. In this study, we aimed to investigate the effects of surgical and medical treatments on the mortality of stable coronary diseases.MethodsA total of 150 geriatric patients who underwent coronary angiography (CAG) were followed up in our cardiology clinic. Patients who decided to undergo coronary artery bypass graft (CABG) surgery after CAG and were willing to undergo the operation were assigned to group 1, whereas those who were unwilling to undergo the operation were not eligible for percutaneous coronary intervention and were followed up medically, and were assigned to group 2. Keeping the primary goal as mortality rates, both the groups were compared using medical records for three years after the treatment.ResultsAfter three years, the overall mortality rate included six patients (16%) in the CABG group versus 63 patients (55%) in the medical therapy group (p < 0.001). The CABG therapy was found to be significantly and independently associated with first- and third-year mortality (risk ratio: 0.064, 95% confidence interval: 0.009-0.467, p = 0.007; risk ratio: 0.305, 95% confidence interval: 0.151-0.615, p < 0.001, respectively). Kaplan-Meier analysis for first- and third-year all-cause mortality rates led to significant results and curves between the groups.ConclusionOur study revealed that compared to CABG surgery in the treatment of coronary artery disease in geriatric patients, medical treatment is associated with poor outcomes in terms of mortality in long-term follow-up.
Highlights
Coronary artery disease (CAD) is an important cause of morbidity and mortality, especially in the elderly, as in adults [1]
Our study revealed that compared to coronary artery bypass graft (CABG) surgery in the treatment of coronary artery disease in geriatric patients, medical treatment is associated with poor outcomes in terms of mortality in long-term follow-up
In geriatric patients, personalized treatment regimens are prominent due to factors such as the patient’s biological age, comorbid conditions, and intolerance to the applied treatment [4]. Risk scores such as Syntax, Gensini, and Grace, which are used in treatment management after coronary angiography (CAG), are used in patients diagnosed with CAD [5]
Summary
Coronary artery disease (CAD) is an important cause of morbidity and mortality, especially in the elderly, as in adults [1]. Advances in healthcare have resulted in an increase in life expectancy and an increase in the number of hospital admissions for elderly individuals in need of medical care Since risk factors such as hypertension (HT), diabetes mellitus (DM), and obesity are more common in advanced ages, an increase in the prevalence of CAD has been observed worldwide [2]. In geriatric patients, personalized treatment regimens are prominent due to factors such as the patient’s biological age, comorbid conditions, and intolerance to the applied treatment [4] Risk scores such as Syntax, Gensini, and Grace, which are used in treatment management after coronary angiography (CAG), are used in patients diagnosed with CAD [5]. We aimed to investigate the effects of surgical and medical treatments on the mortality of stable coronary diseases
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