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Rational Pharmacotherapy in Cardiology

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Comorbidities and Percutaneous Coronary Intervention in Elderly Patients with Acute Coronary Syndrome

https://doi.org/10.20996/1819-6446-2021-04-10

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Abstract

Aim. To assess comorbidities in elderly patients with acute coronary syndrome (ACS) and to analyze patient subgroups with different treatment strategies in the Regional Vascular Center (RVC).

Material and methods. The prospective study included 205 patients with confirmed ACS 75 years and older, the mean age was 81±4.9 years, and 68% were women. ST segment elevation myocardial infarction (STEMI) was diagnosed in 46 (22.4 %) patients, non-ST segment elevation myocardial infarction (NSTEMI) was diagnosed in 159 (77,6 %) patients. The Charlson Comorbidity Index (CCI) was calculated in every patient. Early outcomes were defined as those assessed during hospital stay. Late outcomes were assessed at 6 months after the discharge using phone calls and/or clinic visits. All patients provided written informed consent.

Results. Percutaneous coronary intervention (PCI) was performed in 42% of patients. In patients with STEMI and NSTEMI PCI was performed in 73% and 32%, respectively. Mean CCI score was 7.9 points: 7.6 points in men and 8.04 in women. Patients with STEMI had higher CCI score than NSTEMI patients (p<0.01): 8.1 points and 7.1 points, respectively. Patients who underwent PCI had lower CCI score (7.2 points) than patients in non-PCI group (8.2 points; p<0.05). Patients with STEMI in PCI and non-PCI groups had significant difference in CCI score (p<0.05): 7.4 and 8.4 points, respectively. Mean CCI score in patients who died in hospital was 8.5 while discharged patients had 7.6 points (p<0.01). In 6 months 13 patients (6.3%) died, their mean age was 84.9 years, mean CCI was 9 points, PCI was performed in 3 (23%) patients.

Conclusions. Elderly patients with ACS had high comorbidity level assessed by CCI score. Higher CCI score was associated with PCI non-performance in elderly patients. Elderly patients with STEMI had higher CCI score than patients with NSTEMI which was significantly associated with PCI non-performance. Patients who died in hospital or in 6 months after the ACS onset had higher CCI score than other elderly patients with ACS.

About the Authors

M. Yu. Gilyarov
City Clinical Hospital №1 n.a. N.I. Pirogov; Pirogov Russian National Research Medical University; I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Mikhail Yu. Gilyarov - eLibrary SPIN 7713-6726

Moscow



E. V. Konstantinova
City Clinical Hospital №1 n.a. N.I. Pirogov; Pirogov Russian National Research Medical University
Russian Federation

Ekaterina V. Konstantinova - eLibrary SPIN 3156-9983

Moscow



M. R. Atabegashvili
City Clinical Hospital №1 n.a. N.I. Pirogov
Russian Federation

Maria R. Atabegashvili - eLibrary SPIN 4975-1866

Moscow



T. D. Solntseva
Research Institute of Cardiology named after A.L. Myasnikov, National Medical Research Center of Cardiology
Russian Federation

Tatiana D. Solnceva - eLibrary SPIN 6073-1072

Moscow



D. A. Anichkov
Pirogov Russian National Research Medical University
Russian Federation

Dmitrii A. Anichkov - eLibrary SPIN 2891-6763

Moscow



А. N. Kostina
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Anna N. Kostina - eLibrary SPIN 4064-5691

Moscow



R. V. Polybin
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Roman V. Polibin - eLibrary SPIN 1831-0444

Moscow



A. E. Udovichenko
City Clinical Hospital №1 n.a. N.I. Pirogov; Pirogov Russian National Research Medical University; I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Anna E. Udovichenko - eLibrary SPIN 5135-0453

Moscow



A. V. Svet
City Clinical Hospital №1 n.a. N.I. Pirogov; I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Alexey V. Svet - eLibrary SPIN 3401-5653

Moscow



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For citation:


Gilyarov M.Yu., Konstantinova E.V., Atabegashvili M.R., Solntseva T.D., Anichkov D.A., Kostina А.N., Polybin R.V., Udovichenko A.E., Svet A.V. Comorbidities and Percutaneous Coronary Intervention in Elderly Patients with Acute Coronary Syndrome. Rational Pharmacotherapy in Cardiology. 2021;17(2):221-227. https://doi.org/10.20996/1819-6446-2021-04-10

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ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)