Emergency coronary angiography in a 90-plus population: outcomes at 5-year follow-up

Submitted: January 14, 2023
Accepted: February 13, 2023
Published: February 21, 2023
Abstract Views: 961
PDF: 245
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Authors

Elderly people represent a vulnerable and increasing population presenting with acute coronary syndrome (ACS). Our goal was to evaluate a group of very old patients who underwent emergency coronary angiography (CA). We retrospectively analyzed a group of very old patients (≥90 years old) who underwent emergency CA from 2008 to 2020. Survival and major adverse cardiovascular events (MACE) (a composite of all-cause death, ischemic stroke, ACS, or hospitalization for acute heart failure) were compared with an aged-matched control population with ACS not submitted to emergency CA. A total of 34 patients were enrolled, 56% of whom were female, with a median age of 92 years old. Almost all patients had ST elevation-ACS. In CA, 65% had multivessel disease, and coronary intervention was performed in 71%. More than one-third evolved in Killip class III/IV, and 70% had left ventricular dysfunction. Regarding mortality, 38% of patients died in the index event versus 25% in the aged-matched control group (p=0.319). During 5 years of follow-up, there was no significant difference in mortality between the 2 groups (Log-rank=0.403) and more than 50% of patients died in 2 years. Comparing MACE occurrence, both groups were similar (Log-rank=0.662), with more than 80% having at least one event in 5 years. Very old patients submitted to emergency CA had a high rate of multivessel disease and left ventricular dysfunction, in-hospital and follow-up mortality, and MACE. Compared to an aged-matched control group not submitted to emergency CA, they showed no survival or MACE benefit during a 5-year follow-up.

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Citations

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Ethics Approval

This study was approved by the institutional ethics committee.

How to Cite

Proença, Tânia, Ricardo Alves Pinto, Miguel Martins Carvalho, Paula Dias, and Filipe Macedo. 2023. “Emergency Coronary Angiography in a 90-Plus Population: Outcomes at 5-Year Follow-up”. Monaldi Archives for Chest Disease 94 (1). https://doi.org/10.4081/monaldi.2023.2526.

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