Age related differences in acute coronary syndrome presentation and in hospital outcomes: a cross-sectional comparative study

Mirghani, Hyder Osman

doi:10.11604/pamj.2016.24.337.8711

Cited by 3 publications

(2 citation statements)

References 9 publications

(11 reference statements)

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“…A noticeable discrepancy is apparent between the unadjusted mortality outcomes seen in the Kaplan-Meier curves and the adjusted ones seen in the Cox model. As seen in many ACS outcomes studies, age is a strong outcome predictor [18][19][20]. Our analysis suggests that the age difference between the groups -polycythemic patients were 5 years younger than normal hemoglobin patients and 15 years younger than anemic patients -has such an independently significant impact on long-term mortality that without adjustment potentially masks the independent impact of polycythemia.…”

Section: Discussionsupporting

confidence: 49%

Association of Polycythemia with Outcomes of Acute Coronary Syndrome

et al. 2021

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Background: Polycythemia has not been extensively studied for its impact on acute coronary syndrome (ACS) outcomes. A previous study reported only 30-day outcomes to be worse in these patients. Methods: Data from the ACS Israeli survey between 2000 and 2018 were utilized to compare between 3 groups of patients with ACS: anemic group (hemoglobin <12 g/dL for women and <12.5 g/dL for men), normal hemoglobin group, and polycythemic group (>16 g/dL and >16.5 g/dL, respectively). Measured outcomes included 30-day major adverse cardiac events (MACE comprising all-cause mortality, recurrent ACS, need for urgent revascularization, and stroke) and 1- and 5-year all-cause mortality. Results: Of 14,746 ACS patients, 10,752 (72.9%) had normal hemoglobin levels, 3,492 (23.7%) were anemic, and 502 (3.4%) were polycythemic. In comparison with normal and anemic patients, polycythemic patients were younger (55.9 ± 10.5 vs. 61.9 ± 12.4 and 71.1 ± 12.2 for anemic, respectively, p < 0.001 for both), more frequently men (93.8% vs. 81.3% and 63.1%, respectively, p < 0.001), and less likely diabetic or hypertensive. Upon adjustment to baseline characteristics, compared with normal hemoglobin, polycythemia was not independently associated with 30-day MACE or 1-year mortality, but it was independently associated with higher risk for 5-year mortality (HR 1.76, 95% CI: 1.19–2.59, p = 0.005). Similar results were observed after propensity score matching. Conclusions: Although younger and with fewer comorbidities, polycythemic ACS patients are at increased risk for long-term all-cause mortality. Further study of this association is warranted to understand the causes and possibly to improve the outcomes of these patients.

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Section: Discussionsupporting

confidence: 49%

Association of Polycythemia with Outcomes of Acute Coronary Syndrome

et al. 2021

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“…Kanoo Manado which shows the ratio of the incidence of ACS between men and women was 7: 3. Based on the results of their study, men are more susceptible to ACS due to the risk factors such as smoking and hypercholesterolemia [16].…”

Section: A Subject Characteristicsmentioning

confidence: 99%

Elevated Cardiac Marker Enzymes with the Incidence of Complications in ACS Patients:

Pujowaskito¹,

Alhadiyanto²,

Aziz³

et al. 2021

Advances in Health Sciences Research

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Acute coronary syndrome (ACS) is a condition that describes the condition of the heart muscle infarction so that the heart is damaged. Ongoing damage to the heart muscle may result in a new condition known as a complication. Based on this condition, the aim of this study was to determine the relationship between elevated cardiac marker enzymes and the incidence of complications in ACS patients. This study is an observational analytic study based on secondary data, namely medical record data. The subjects of this study were data from medical records of SKA patients who experienced complications recorded in the medical records at the Dustira Cimahi Hospital in 2018. The number of cases found in the Dustira hospital in 2018 was 105 cases, the most age was over 45 years, the sex that often experienced complications was women with a total of 58 people (55.2%), cardiac enzymes both troponin and CKMB in cases experienced a significant increase, patients with troponin increase was 86 people (81.9%) while patients with increased CKMB were 88 people (92.6%), complications were obtained by patients with heart failure as many as 38 cases, cardiogenic shock as many as 16 people, arrhythmia as many as 30 people, as many as 11 people, and cardiac arrest as many as 10 people. In this study, it was concluded that there was a significant relationship between the increase in cardiac marker enzymes both troponin and CKMB (p-value <0.05) on the incidence of complications in ACS patients.

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Non-ST elevation acute coronary syndromes; clinical landscape, management strategy and in-hospital outcomes: an age perspective

Dakhil

Farhan

2021

Egypt Heart J

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Background As the elderly represent a substantial proportion of medical care beneficiaries, and there is limited data about age disparity in emerging countries, this study sought to investigate the impact of age on the management in patients with non-ST elevation acute coronary syndromes (NSTE-ACS). Results Two hundred patients with NSTE-ACS enrolled prospectively, patients’ data, pharmacotherapy, management strategy as well timing to catheterization were documented. Patients grouped into ≥ 65 years versus < 65 years; 32.5% were ≥ 65-year-old. The older group presented as high GRACE risk (Global Registry of Acute Coronary Events) (67.7% versus 15.6%). Elderly patients were less likely to be referred for catheterization compared with younger counterparts (55.4% versus 76.3%, p = 0.003). Within low risk class patients, none of the elderly versus 9.33% of younger patients were catheterized within 2 h; in the same line, none of the elderly versus 16% of younger patients were catheterized within 24 h. Alternatively, at high risk class, 6.81% of the elderly and none of the younger patients were catheterized within 2 h. On the univariate analysis of variables to predict invasive strategy, presence of history of prior IHD, diabetes, absent in-hospital acute heart failure or atrial fibrillation/flutter, higher haemoglobin and lower creatinine levels predicted the use of invasive strategy, while on multivariate analysis, acute heart failure (95% CI − 0.38 to − 0.41, p = 0.01), lower haemoglobin (95% CI 0.002–0.07, p = 0.03), and atrial fibrillation/flutter (95% CI − 0.48 to − 0.02, p = 0.03) predicted conservative strategy. The elderly were more likely to have acute heart failure (32.3% versus 14.8%, p = 0.004), same as stroke (3.1% versus none, p = 0.04). Conclusions Less-invasive strategy used in the elderly with NSTE-ACS compared with younger counterparts, yet age was not a predictor of catheterization underuse on multivariate analysis. It is crucial to bridge the age gap in the healthcare system in setting of ACS management by grasping the attention of decision makers and emphasizing on the adherence of healthcare providers to the guidelines to improve cardiovascular care and outcomes.

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Age related differences in acute coronary syndrome presentation and in hospital outcomes: a cross-sectional comparative study

Cited by 3 publications

References 9 publications

Association of Polycythemia with Outcomes of Acute Coronary Syndrome

Association of Polycythemia with Outcomes of Acute Coronary Syndrome

Elevated Cardiac Marker Enzymes with the Incidence of Complications in ACS Patients:

Non-ST elevation acute coronary syndromes; clinical landscape, management strategy and in-hospital outcomes: an age perspective

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