Long term survival in elderly patients with stable coronary disease

Ortiz, Martín Ruiz; Luque, Cristina Ogayar; Romo, Elías; Mesa, Dolores; Delgado, Mónica; Anguita, Manuel; Castillo, Juan Carlos; Granados, Amador López; Prado, José María Arizón del; Lezo, Javier Suárez de

doi:10.1093/eurheartj/eht309.p4012

Cited by 2 publications

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“…Characteristics and outcomes of patients with stable CAD have been well characterized in large studies/registries [9,18–21]. However, the patients in these studies were relatively young (mean age: 60–67 years) and there are limited data in the current literature regarding specificities of stable CAD in elderly populations [22,23]. In the present study, we focused on older adults (≥85 years) who had evidence of CAD but no MI or coronary revascularization within last year.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, while there has been documentation of high mortality rates in elderly patients with acute manifestations of CAD [3,6] or recent coronary revascularization [25], follow-up data in elderly patients enrolled in a stable CAD setting are lacking. In the Trial of Invasive versus Medical therapy in Elderly (TIME) patients with chronic angina [22], the mortality rate in 148 patients ≥75 years (mean age: 80 years) with medical strategy was 6.6% per year, while in a cohort by Ruiz Ortiz et al [23], the mortality rate in 391 patients ≥75 years (median age: 78 years) was 5.5% per year. Patients were included in these studies in 1996–2000 [22] and 2000–2007 [23], when the use of evidence-based medications for stable CAD was not as high as in the more recent period.…”

Section: Discussionmentioning

confidence: 99%

“…In the Trial of Invasive versus Medical therapy in Elderly (TIME) patients with chronic angina [22], the mortality rate in 148 patients ≥75 years (mean age: 80 years) with medical strategy was 6.6% per year, while in a cohort by Ruiz Ortiz et al [23], the mortality rate in 391 patients ≥75 years (median age: 78 years) was 5.5% per year. Patients were included in these studies in 1996–2000 [22] and 2000–2007 [23], when the use of evidence-based medications for stable CAD was not as high as in the more recent period. The present study focused on much older patients (median age: 87 years), included in 2010–2011.…”

Section: Discussionmentioning

confidence: 99%

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Very long-term outcomes of older adults with stable coronary artery disease (from the CORONOR study)

Abbadi

Lemesle

Lamblin

et al. 2021

Coronary Artery Disease

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Background There are limited data on stable coronary artery disease (CAD) in the very elderly. The present study aimed to investigate incident cardiovascular events and mortality in older adults (≥85 years) included in a multicenter registry on stable CAD.Methods A long-term follow-up was performed in 198 patients ≥85 years with stable CAD, free from myocardial infarction (MI) or coronary revascularization within the year. The median age was 87 years. Clinical events during the follow-up period [death, MI, ischemic stroke, coronary revascularization and hospitalization for heart failure (HF)] were centrally adjudicated. ResultsThere were 164 deaths during follow-up. The cumulative risk of all-cause death was 9.1% at 1 year, 53.9% at 5 years and 85.5% at 10 years. The cause of death was adjudicated as cardiovascular in 64 patients with death from HF in 36 patients. Male gender, previous hospitalization for HF and an estimated glomerular filtration rate <60 ml/min/1.73 m 2 were independently associated with all-cause death. Ten-year cumulative incidences of MI, ischemic stroke and coronary revascularization were low (6.6, 7.7 and 6.6%, respectively). By contrast, the 10-year cumulative incidence of hospitalization for HF was high (27.8%). ConclusionThe 10-year mortality of elderly patients with stable CAD is very high. While ischemic events are relatively unfrequent, HF events are frequent and represent the most common cause of cardiovascular death in this population. Prevention and management of HF are important goals for physicians in charge of older adults with stable CAD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Very long-term outcomes of older adults with stable coronary artery disease (from the CORONOR study)

Abbadi

Lemesle

Lamblin

et al. 2021

Coronary Artery Disease

View full text Add to dashboard Cite

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“…[2] CAD patients at stable stage are still threatened by recurrent cardiovascular events and higher risk of mortality. [3,4] Therefore, risk stratification is very important for secondary prevention in stable CAD patients.…”

Section: Introductionmentioning

confidence: 99%

Predictive value of baseline C-reactive protein level in patients with stable coronary artery disease: A meta-analysis

Luo

Zhang

et al. 2022

Medicine

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Background: Conflicting results have been reported on the association of C-reactive protein (CRP) level with adverse outcomes in patients with stable coronary artery disease (CAD). The objective of this meta-analysis was to evaluate the predictive value of baseline CRP level in stable CAD patients.Methods: Two reviewers independently searched PubMed and Embase databases from their inception to November 28, 2021 to identify studies assessing the value of baseline CRP level in predicting adverse outcomes in stable CAD patients. The endpoints of interest included cardiovascular mortality, all-cause mortality, or major adverse cardiovascular events (MACEs). The predictive value of CRP level was estimated by pooling the multivariable adjusted risk ratio with 95% confidence intervals (CI) compared the highest to the lowest CRP level.Results: Twenty-six studies involving of 22,602 patients with stable CAD satisfied the inclusion criteria. In a comparison of the highest with the lowest CRP level, the pooled multivariable adjusted risk ratio was 1.77 (95% CI 1.60-1.96) for MACEs, 1.64 (95% CI 1.13-2.33) for cardiovascular mortality, and 1.62 (95% CI 2.62-5.12) for all-cause mortality, respectively. Subgroup analyses indicated that the values of elevated CRP level in predicting MACEs were consistently observed in each subgroup.Conclusion: Elevated baseline CRP level was an independent predictor of MACEs, cardiovascular mortality, and all-cause mortality in patients with stable CAD. Baseline CRP level can provide important predictive information in stable CAD patients.Abbreviations: CAD = coronary artery disease, CI = confidence intervals, CRP = C-reactive protein, MACEs = major adverse cardiovascular events, RR = risk ratio.

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Long term survival in elderly patients with stable coronary disease

Cited by 2 publications

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Very long-term outcomes of older adults with stable coronary artery disease (from the CORONOR study)

Very long-term outcomes of older adults with stable coronary artery disease (from the CORONOR study)

Predictive value of baseline C-reactive protein level in patients with stable coronary artery disease: A meta-analysis

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