Long‐term survival in elderly patients with stable coronary disease. (9th May 2013)

• Record Type: Journal Article
• Authors: Ruiz Ortiz, Martín; Ogayar, Cristina; Romo, Elías; Mesa, Dolores; Delgado, Mónica; Anguita, Manuel; Castillo, Juan C.; Arizón, José M.; Suárez de Lezo, José
• Is Part Of: European journal of clinical investigation. Volume 43:Number 8(2013:Aug.)
• Page Start: 774
• Page End: 782
• Publication Date: 2013-05-09
• Subjects: Pathology -- Periodicals; Medical research -- Periodicals; 616.075
• DOI: 10.1111/eci.12105
• Languages: English
• ISSNs: 0014-2972

Abstract

<abstract abstract-type="main" xml:lang="en" id="eci12105-abs-0001"> <title>Abstract</title> <sec id="eci12105-sec-0001" sec-type="section"> <title>Background</title> <p>This study aimed to assess long‐term prognosis of stable coronary artery disease (sCAD) in patients aged ≥ 75 years and to identify clinical predictors of cardiovascular and overall mortality.</p> </sec> <sec id="eci12105-sec-0002" sec-type="section"> <title>Materials and Methods</title> <p>From February 2000 to January 2007, 391 outpatients aged ≥ 75 years (median 78 years, interquartile range [IQR] 76–81 years, 66% male) with sCAD were recruited in this prospective cohort study. Associations of baseline variables with long‐term cardiovascular and all‐cause death were investigated.</p> </sec> <sec id="eci12105-sec-0003" sec-type="section"> <title>Results</title> <p>After up to 11 years of follow‐up (median 4 years, IQR 2–6 years), 89 patients died (23%, 5·45%/year), 35 from cardiovascular causes (9%, 2·14%/year). Multivariate analysis identified family history of coronary disease (HR 4·28, 95% CI 1·22–15·02, <italic>P</italic> = 0·02), baseline atrial fibrillation (HR 3·18, 95% CI 1·37–7·39, <italic>P</italic> = 0·007), age (HR 1·61 per 5 year increase, 95% CI 1·04–2·50, <italic>P</italic> = 0·03), resting heart rate (HR 1·26 per 5 bpm increase, 95% CI 1·09–1·47, <italic>P</italic> = 0·003) and previous revascularization (HR 0·17, 95% CI 0·04–0·77, <italic>P</italic> = 0·02) as independent predictors of cardiovascular death, and previous acute coronary syndrome (HR 4·93, 95% CI 1·49–16·30, <italic>P</italic> = 0·009), baseline atrial fibrillation (HR 1·96, 95% CI 1·12–3·43, <italic>P</italic> = 0·02), tobacco use (HR 1·69, 95% CI 1·00–2·84, <italic>P</italic> = 0·049 for ex‐smoking and HR 6·78, 95% CI 0·89–51·47, <italic>P</italic> = 0·06 for active smoking), age (HR 1·58 per 5 year increase, 95% CI 1·18–2·11, <italic>P</italic> = 0·002), resting heart rate (HR 1·10 per 5 bpm increase, 95% CI 1·00–1·22, <italic>P</italic> = 0·05) and diastolic blood pressure (HR 0·97, 95% CI 0·94–0·99, <italic>P</italic> = 0·01) as independent predictors of overall mortality.</p> </sec> <sec id="eci12105-sec-0004" sec-type="section"> <title>Conclusions</title> <p>In this study, 4‐years overall mortality was 23% among elderly patients with sCAD. Simple clinical variables can identify patients at higher risk of mortality.</p> </sec> </abstract>