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TRENDS IN MORTALITY RATES FROM ACUTE CORONARY SYNDROME OCTOGENARIAN PATIENTS IN ISRAEL DURING THE PERIOD 2000-2013
A77 JACC March 17, 2015 Volume 65, Issue 10S
Acute Coronary Syndromes Trends in Mortality Rates from Acute Coronary Syndrome Octogenarian Patients in Israel During the Period 2000-2013 Poster Contributions Poster Hall B1 Saturday, March 14, 2015, 3:45 p.m.-4:30 p.m. Session Title: Insights from Subgroups: Age, Gender and Diabetes Abstract Category: 2. Acute Coronary Syndromes: Clinical Presentation Number: 1138-056 Authors: Michael Shechter, Ilan Goldenberg, Shlomi Matetzky, on behalf of the ACSIS investigators, Leviev Heart Center, Chaim Sheba Medical Center, Tel Hashomer, Israel, The Sackler Faculty of Medicine, Tel Aviv, Israel Background: Few data are available regarding the outcome of octogenarians with acute coronary syndrome (ACS).
Methods: We evaluated in-hospital and 30-day clinical outcome of 13,432 patients [1,731 (13%) ≥ and 11,701 (87%) < 80 years old] from the ACS Israel Survey (ACSIS), by analyzing data from ACS patients hospitalized in all coronary care units in Israel during two-month periods/year during the period 2000 to 2013.
Results: The annual hospitalization rate of ACS patients ≥ 80 years (12%) and females (40%) remained steady and unchanged over time. Patients ≥ 80 years (mean age 85±4) had a higher incidence of risk factors, prior cardio-cerebrovascular events, chronic renal failure and cardiac medication use compared to patients < 80 years (mean age 61±11). Time from onset of chest pain to hospitalization and to myocardial infarction (MI) were similar in both groups. Killip class on admission was higher, while left ventricular ejection fraction was lower in ACS ≥ compared to < 80 years. ST elevation MI on admission was more common in ACS patients < than ≥ 80 years (41% vs 31%). In-hospital and 30-day mortality rates were significantly lower in patients ≥ 80 years who underwent, compared with those who did not undergo primary percutaneous coronary interventions (PCI). There was a significant increase in the use of PCI over time among ACS patients ≥ 80 years (19% vs. 57%, p<0.001; respectively). Furthermore, in-hospital (15.6% vs. 6.4%, p<0.05) and 30-day (23.7% vs. 9.7%, p<0.05) mortality rates were significantly reduced. While the absolute reduction in 30-day mortality in patients < 80 years between 2000 and 2013 was 2%, and statistically significant, the 30-day mortality in those ≥ 80 years was significantly higher and reached 14% (p<0.02). Conclusion: Although there was a significant in-hospital and 30-day mortality reduction over time in ACS patients in Israel, the absolute percent reduction in 30-day mortality was significantly higher in octogenarian ACS patients compared to those < 80 years.
Acute Coronary Syndromes Trends in Mortality Rates from Acute Coronary Syndrome Octogenarian Patients in Israel During the Period 2000-2013 Poster Contributions Poster Hall B1 Saturday, March 14, 2015, 3:45 p.m.-4:30 p.m. Session Title: Insights from Subgroups: Age, Gender and Diabetes Abstract Category: 2. Acute Coronary Syndromes: Clinical Presentation Number: 1138-056 Authors: Michael Shechter, Ilan Goldenberg, Shlomi Matetzky, on behalf of the ACSIS investigators, Leviev Heart Center, Chaim Sheba Medical Center, Tel Hashomer, Israel, The Sackler Faculty of Medicine, Tel Aviv, Israel Background: Few data are available regarding the outcome of octogenarians with acute coronary syndrome (ACS).
Methods: We evaluated in-hospital and 30-day clinical outcome of 13,432 patients [1,731 (13%) ≥ and 11,701 (87%) < 80 years old] from the ACS Israel Survey (ACSIS), by analyzing data from ACS patients hospitalized in all coronary care units in Israel during two-month periods/year during the period 2000 to 2013.
Results: The annual hospitalization rate of ACS patients ≥ 80 years (12%) and females (40%) remained steady and unchanged over time. Patients ≥ 80 years (mean age 85±4) had a higher incidence of risk factors, prior cardio-cerebrovascular events, chronic renal failure and cardiac medication use compared to patients < 80 years (mean age 61±11). Time from onset of chest pain to hospitalization and to myocardial infarction (MI) were similar in both groups. Killip class on admission was higher, while left ventricular ejection fraction was lower in ACS ≥ compared to < 80 years. ST elevation MI on admission was more common in ACS patients < than ≥ 80 years (41% vs 31%). In-hospital and 30-day mortality rates were significantly lower in patients ≥ 80 years who underwent, compared with those who did not undergo primary percutaneous coronary interventions (PCI). There was a significant increase in the use of PCI over time among ACS patients ≥ 80 years (19% vs. 57%, p<0.001; respectively). Furthermore, in-hospital (15.6% vs. 6.4%, p<0.05) and 30-day (23.7% vs. 9.7%, p<0.05) mortality rates were significantly reduced. While the absolute reduction in 30-day mortality in patients < 80 years between 2000 and 2013 was 2%, and statistically significant, the 30-day mortality in those ≥ 80 years was significantly higher and reached 14% (p<0.02). Conclusion: Although there was a significant in-hospital and 30-day mortality reduction over time in ACS patients in Israel, the absolute percent reduction in 30-day mortality was significantly higher in octogenarian ACS patients compared to those < 80 years.