Non-ST segment elevation myocardial infarction in the elderly

Jiménez-Méndez, César; Díez‐Villanueva, Pablo; Alfonso, Fernándo

doi:10.31083/j.rcm2203084

Cited by 12 publications

(14 citation statements)

References 54 publications

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“…Demographic information and medical history, including hypertension, diabetes, MI, prior coronary revascularization, stroke, information on medications before and during admission, and the percentage of very old patients were collected from medical records by three experienced data inspectors [ 14 ]. The type of AMI, STEMI or NSTEMI, was recorded.…”

Section: Methodsmentioning

confidence: 99%

The association between serum uric acid / serum creatinine ratio and in-hospital outcomes in elderly patients with acute myocardial infarction

Jiang,

Jin,

et al. 2024

BMC Cardiovasc Disord

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Background The role of Serum uric acid (SUA) in acute myocardial infarction (AMI) was controversial, which might be influenced by the renal clearance function of the patients. The present study aimed to explore the association between serum uric acid to serum creatinine ratio (SUA/Scr), reflecting a net production of SUA, and the in-hospital outcomes of elderly patients with AMI. Methods In this retrospective study, a total of 330 elderly AMI patients (≥ 75 years) were enrolled. Data of SUA and Scr on admission were collected to calculate SUA/Scr ratio. Logistic regression analysis and receiver-operating curves were performed to assess the association between SUA/Scr ratio and in-hospital major adverse cardiovascular events (MACEs) and all-cause death. Results Among the 330 patients, 68 patients had MACEs and 44 patients died. Patients with MACEs or died had lower SUA/Scr values compared with those without MACEs or survival (P < 0.05). Univariate logistic analysis showed that a lower value of SUA/Scr (< 3.45) was significantly associated with in-hospital MACEs (odd ratios (OR): 2.359, 95% confidential interval (CI): 1.369–4.065, P = 0.002) and death (OR: 2.424, 95% CI: 1.275–4.608, P = 0.007). After correcting for confounding factors, a lower SUA/Scr value was still independently associated with in-hospital MACEs (OR: 2.144, 95% CI: 1.169–3.934, P = 0.014) and death (OR: 2.125, 95% CI: 1.050–4.302, P = 0.036). Subgroup analysis showed that the association between a lower SUA/Scr ratio and increased risk of in-hospital outcomes could observed only in males (OR: 2.511, 95%CI: 1.211–5.207, P = 0.013 for MACEs; OR: 2.730, 95% CI: 1.146–6.502, P = 0.023 for death). Conclusions A lower SUA/Scr ratio was associated with an increased risk of in-hospital adverse events in elderly patients with AMI, especially in males, which maybe a marker of poor outcomes for elderly AMI patients.

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Section: Methodsmentioning

confidence: 99%

The association between serum uric acid / serum creatinine ratio and in-hospital outcomes in elderly patients with acute myocardial infarction

Jiang,

Jin,

et al. 2024

BMC Cardiovasc Disord

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“…However, the benefit of routine use of an invasive approach is not as clear in older patients with NSTEMI, with the available evidence showing contradictory results [20]. The After Eighty randomized trial demonstrated a significant benefit of an early invasive approach in older patients with NSTEMI [21].…”

Section: Revascularization Approachmentioning

confidence: 99%

The Impact of Geriatric Conditions in Elderly Patients with Coronary Heart Disease: A State-of-the-Art Review

Alonso Salinas,

Cepas-Guillén,

León

et al. 2024

JCM

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The growing geriatric population presenting with coronary artery disease poses a primary challenge for healthcare services. This is a highly heterogeneous population, often underrepresented in studies and clinical trials, with distinctive characteristics that render them particularly vulnerable to standard management/approaches. In this review, we aim to summarize the available evidence on the treatment of acute coronary syndrome in the elderly. Additionally, we contextualize frailty, comorbidity, sarcopenia, and cognitive impairment, common in these patients, within the realm of coronary artery disease, proposing strategies for each case that may assist in therapeutic approaches.

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“…Aging is a vital risk factor for its prevalence and poor clinical outcomes. Almost a third of patients admitted for ACS and two-thirds of those dying from ACS are >75 years old (3,4). Multi-comorbidities, complicated coronary artery lesions, and high prevalence of frailty in the oldest-old have increased the risk of re-infarcted, bleeding complications, and mortality when compared to younger patients (5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

Geriatric nutritional risk index predicts all-cause mortality in the oldest-old patients with acute coronary syndrome: A 10-year cohort study

Liu

Shen²,

Hou³

et al. 2023

Front. Nutr.

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Background and objectiveNutritional status assessment in acute coronary syndrome (ACS) patients has been neglected for a long time. The geriatric nutritional risk index (GNRI) is a sensitive indicator for assessing the nutritional status of the elderly. This study aims to explore the association between GNRI and all-cause mortality in the oldest-old patients with ACS.MethodsThe patients who met the inclusion criteria were consecutively enrolled from January 2006 to December 2012. Clinical data were collected on admission, and all subjects were followed after being discharged. The nutritional status was evaluated using GNRI. The relationship between GNRI and all-cause mortality was assessed by using different analyses.ResultsA total of 662 patients with a mean age of 81.87 ± 2.14 years old were included in our study, and followed (median: 63 months, IQR 51–71). Patients whose GNRI ≤ 98 were reported as at risk of malnutrition (31.11%, n = 206). In multivariable analysis, we found that for each SD increase in GNRI, the risk of all-cause mortality lowered by 23%, and the HR for GNRI ≤ 98 was 1.39 (95% CI 1.04–1.86). After stratifying patients into three groups by tertiles of GNRI, we found that the HRs for tertile 2 and tertile 3 were 1.49 (95% CI 1.02–2.19) and 1.74 (95% CI 1.22–2.50), respectively. The trend test revealed a dose–response relationship between GNRI and all-cause mortality in the oldest-old with ACS. Lastly, in subgroup analyses, we found a reliable association between GNRI and all-cause mortality.ConclusionMalnutrition is common in the oldest-old patients with ACS, and GNRI could predict their long-term all-cause mortality in a dose-dependent manner. GNRI may be a prospective index for risk-stratification and secondary-prevention in the oldest-old patients with ACS.

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Non-ST segment elevation myocardial infarction in the elderly

Cited by 12 publications

References 54 publications

The association between serum uric acid / serum creatinine ratio and in-hospital outcomes in elderly patients with acute myocardial infarction

The association between serum uric acid / serum creatinine ratio and in-hospital outcomes in elderly patients with acute myocardial infarction

The Impact of Geriatric Conditions in Elderly Patients with Coronary Heart Disease: A State-of-the-Art Review

Geriatric nutritional risk index predicts all-cause mortality in the oldest-old patients with acute coronary syndrome: A 10-year cohort study

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