Clinical outcomes and prognostic factors in very elderly women with ACS treated with successful PCI. (25th November 2020)

• Record Type: Journal Article
• Authors: Zhao, S.M; Wang, J; Chen, H; Zhao, H.Q; Zhao, X.Q; Li, H.W
• Is Part Of: European heart journal. Volume 41:(2020)Supplement 2
• Publication Date: 2020-11-25
• Subjects: Acute Coronary Syndromes: Treatment, Revascularization; Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; 616.12005
• DOI: 10.1093/ehjci/ehaa946.1742
• Languages: English
• ISSNs: 0195-668X

Abstract

Abstract: Background: Whether elderly women over 80 years old with acute coronary syndrome (ACS) should actively receive PCI treatment is still controversial. Purpose: We assessed the effectiveness and long-term clinical outcomes of PCI in very elderly women patients, and detected predictive factors which contributed to the major adverse cardiovascular and cerebrovascular events (MACCE). Methods: Female ACS patients aged ≥80 years were continuously enrolled from the hospital database bank (n=729, a mean age of 83.6±3.1 years). All patients were followed up for MACCE: non-fatal MI, stroke, heart failure (HF) re-hospitalization, cardiovascular (CV) death, and the composite of them. Before and after Propensity Score (PS) Matching (1:1), the incidences of MACCE were compared between female PCI group (n=232) and medical group (n=497). Clinical and coronary artery characteristics were analyzed in PCI treatment patients with (n=56) and without MACCE (n=176). Multivariate Cox regression analysis was performed to identify risk factors which independently associated with MACCE in female PCI patients. Results: A total of 31.8% women (n=232) received PCI treatment in the retrospective study.Compared to medical group, PCI treatment significantly reduced the incidences of non-fatal MI (6.2%, 20.2%, p<0.001), HF re-hospitalization (10.9%, 22.5%, p=0.012), CV death (12.4%, 28.7%, p<0.001) and the composite MACCE (24.0%, 44.2%, p<0.001) after PS matching (129 patients in PCI group vs 129 patients in medical group)during a follow-up period of 36 (23, 48) months. Meanwhile, there were no significant differences in composite MACCE (24.1% vs 19.7%, p=0.232) and CV death (10.8% vs 10.6%, p=0.951) between very elderly women and men (≥80 years old) treated with PCI during the same period. Multivariate Cox analysis revealed that STEMI (HR 1.944, 95% CI 1.11–3.403, p=0.02) and elevated NT-proBNP (HR 1.689, 95% CI 1.029–2.733, p=0.038) were independently associated with the incidence of composite MACCE, as well as adherence to P2Y12 receptor antagonist (HR 0.119, 95% CI 0.051–0.278, p<0.001) and β-blocker (HR 0.452, 95% CI 0.254–0.805, p=0.007) medications may help to attenuate the risk of MACCE within elderly women treated with PCI. Conclusion: In very elderly women with ACS, PCI treatment significantly decreased the risks of MACCE and improves the long-term clinical outcomes.STEMI and elevated NT-proBNP value were independently associated with the increase of the composite MACCE after PCI in this population. Funding Acknowledgement: Type of funding source: None