Coronary angiographic characteristics in septuagenarian patients with acute coronary syndrome
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Abstract
Background: Although the prognosis of acute coronary syndrome (ACS) in elderly patients is bleak , elderly population is less well treated both in medical and interventional terms.
aims: to analyse angiographic findings in septuagenarian patients admitted with ACS and its impact on the therapeutic strategy.
methods: We retrospectively analysed 250 patients 70 years or older hospitalised for ACS who underwent a coronary angiography between january 2006 to september2010.
results: This population was more likely to be male with mean age 74 years and 93 % of ACS were inaugural events (60% N STEM, 40% STEMI).Coronary angiograms showed complex, diffuse coronary lesions with a high incidence of multivessel coronary artery disease , bifurcation lesions , and calcified stenosis.
Conclusion : Angiographic findings after ACS in elderly were caracterised by multivessel disease and complex lesions .Surgical or percutaneous coronary revascularizaion was possible in the majority of these patients.
aims: to analyse angiographic findings in septuagenarian patients admitted with ACS and its impact on the therapeutic strategy.
methods: We retrospectively analysed 250 patients 70 years or older hospitalised for ACS who underwent a coronary angiography between january 2006 to september2010.
results: This population was more likely to be male with mean age 74 years and 93 % of ACS were inaugural events (60% N STEM, 40% STEMI).Coronary angiograms showed complex, diffuse coronary lesions with a high incidence of multivessel coronary artery disease , bifurcation lesions , and calcified stenosis.
Conclusion : Angiographic findings after ACS in elderly were caracterised by multivessel disease and complex lesions .Surgical or percutaneous coronary revascularizaion was possible in the majority of these patients.
Keywords:
Coronarography, Acute coronary syndrome, elderly.##plugins.themes.academic_pro.article.details##
References
- Ziakas A, Gomma A, McDonald J, Klinke P, Hilton D. A comparison of the radial and the femoral approaches in primary or rescue percutaneous coronary intervention for acute myocardial infarction in the elderly. Acute Card Care 2007; 9:93-6.
- Hanon O, Baixas C, Friocourt P, et al. Consensus of the French Society of Gerontology and Geriatrics and the French Society of Cardiology for the management of coronary artery disease in older adults. Arch Cardiovasc Dis 2009; 102:829-45.
- Dynina O, Vakili BA, Slater JN, et al. In-hospital outcomes of contemporary percutaneous coronary interventions in the very elderly. Catheter Cardiovasc Interv 2003; 58:351-7.
- Kowalchuk GJ, Siu SC, Lewis SM. Coronary artery disease in the octogenarian: angiographic spectrum and suitability for revascularization. Am. J. Cardiol 1990; 66:1319-23.
- Elbaz M, Fourcade J, Carrie D, et al. Coronary artery disease in octogenarians: contribution ocoronary angiography and evaluation of therapeutic possibilities. Arch Mal Coeur Vaiss 1995; 88:1391-8.
- Muñoz JC, Alonso JJ, Duran JM, et al. Coronary stent implantation in patients older than 75 years of age: clinical profile and initial and long-term (3 years) outcome. Am. Heart J 2002; 143:620-6.
- Christiaens L, Mankoubi L, Coisne D, et al. Coronary angiography in octogenarians. Therapeutic impact and medium-term followup. Arch Mal Coeur Vaiss 1998; 91:1125-31.
- Chauhan MS, Kuntz RE, Ho KL, et al. Coronary artery stenting in the aged. J. Am. Coll. Cardiol 2001; 37:856-62.
- Kaiser C, Kuster GM, Erne P, et al. Risks and benefits of optimised medical and revascularisation therapy in elderly patients with angina--on-treatment analysis of the TIME trial. Eur. Heart J 2004; 25:1036-42.
- Boden WE, O'Rourke RA, Teo KK, et al. Impact of optimal medical therapy with or without percutaneous coronary intervention on long-term cardiovascular end points in patients with stable coronary artery disease (from the COURAGE Trial). Am. J. Cardiol 2009; 104:1-4.
- Graham MM, Ghali WA, Faris PD, et al. Survival after coronary revascularization in the elderly. Circulation 2002; 105:2378-84.
- Fox KAA, Anderson Jr FA, Dabbous O H, et al. Intervention in acute coronary syndromes: do patients undergo intervention on the basis of their risk characteristics? The Global Registry of Acute Coronary Events (GRACE). Heart 2007; 93:177-82.
- Alexander KP, Newby LK, Armstrong PW, et al. Acute coronary care in the elderly, part II: ST-segment-elevation myocardial infarction: a scientific statement for healthcare professionals from the American Heart Association Council on Clinical Cardiology: in collaboration with the Society of Geriatric Cardiology. Circulation 2007; 115:2570-89.
- Georgios S, Marie-A M, Pieter K, et al. The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. EuroInterv.2005; 1:219-27.