Therapeutic management and outcome of nonagenarians versus octogenarians admitted to an intensive care unit for acute coronary syndromes

Kochly, Flora; Haddad, Christelle; Harbaoui, Brahim; Falandry, Claire; Lantelme, Pierre; Courand, Pierre‐Yves

doi:10.1016/j.acvd.2020.05.020

Cited by 6 publications

(9 citation statements)

References 33 publications

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“…The mean age was 84.8 (+/-3.8) years. Among the 199 patients, 45 (22.6%), 60 (30.2%) and 94 (47.2%) patients had an EFS score of [0-3], [4][5][6] and [≥ 7], respectively.. The baseline patients' characteristics according to their frailty level are presented in Table 2.…”

Section: Resultsmentioning

confidence: 99%

“…At discharge, cardiovascular medications did not differ among the three groups of frailty, but a tendency of a more frequent prescription of loop diuretic among the frailest patients was observed (p=0.06 Destination at discharge significantly differ among the three groups: frail patients were less likely to be discharged at home (55.6%, 51.9% and 22.4% in the EFS group [0-3], [4][5][6] and [≥7], respectively, p <0.001) (Table 5). The frailest patients were thus most often transferred to a cardiology department of a primary care hospital (close to their place of residence), to a geriatric ward or to post-acute care and rehabilitation at discharge.…”

Section: Resultsmentioning

confidence: 99%

“…At the end of the follow-up period, the global survival rate was 74.9%. The survival rate was 95.6%, 78.3% and 62.8% in the [0-3], [4][5][6] and [ 7] EFS-score group (log rank test, p <0.001) (Table 6). The Kaplan-Meier survival curves according to the frailty level are presented in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…As a result, the prevalence of older patients in cardiac intensive care unit (CICU) is high: according to the FAST MI registry data, 29% of patients admitted in 2015 for Acute Coronary Syndrome (ACS) in CICU were 75 or older 3 . Octogenarians, and nonagenarians are therefore frequently admitted to CICU 4 . This proportion of elderly people in CICU is predicted to increase in the next decades as INSEE (French national institute for statistical and economic studies) analyses predict for France that proportion of population aged 75 or over -that represented 9.3% of the population on January 1 st 2019 -will double by 2080.…”

Section: Introductionmentioning

confidence: 99%

“… 3 Octogenarians, and nonagenarians, are therefore frequently admitted to CICUs. 4 This proportion of elderly people in CICUs is predicted to increase in the next decades, as analyses by the French National Institute for Statistical and Economic Studies (INSEE) predict for France that the proportion of the population aged ≥ 75 years—which represented 9.3% of the population on January 1st 2019—will double by 2080.…”

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confidence: 99%

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Prevalence and Prognosis Impact of Frailty Among Older Adults in Cardiac Intensive Care Units

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Prevalence and Prognosis Impact of Frailty Among Older Adults in Cardiac Intensive Care Units

et al. 2021

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Antithrombotic strategies in elderly patients with acute coronary syndrome

Dillinger¹,

Laine²,

Bouajila³

et al. 2021

Archives of Cardiovascular Diseases

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Nonagenarians admission and prognosis in a tertiary center intensive coronary care unit – a prospective study

et al. 2023

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Background With increasing life expectancy, the prevalence of nonagenarians with cardiovascular disease is steadily growing. However, this population is underrepresented in randomized trials and thus poorly defined, with little quality evidence to support and guide optimal management. The aim of the present study was to evaluate the clinical management, therapeutic approach, and outcomes of nonagenarians admitted to a tertiary care center intensive coronary care unit (ICCU). Methods We prospectively collected all patients admitted to a tertiary care center ICCU between July 2019 – July 2022 and compared nonagenarians to all other patients. The primary outcome was in-hospital mortality. Results A total of 3807 patients were included in the study. Of them 178 (4.7%) were nonagenarians and 93 (52%) females. Each year the prevalence of nonagenarians has increased from 4.0% to 2019, to 4.2% in 2020, 4.6% in 2021 and 5.3% in 2022. Admission causes differed between groups, including a lower rate of acute coronary syndromes (27% vs. 48.6%, p < 0.001) and a higher rate of septic shock (4.5% vs. 1.2%, p < 0.001) in nonagenarians. Nonagenarians had more comorbidities, such as hypertension, renal failure, and atrial fibrillation (82% vs. 59.6%, 23% vs. 12.9%, 30.3% vs. 14.4% p < 0.001, respectively). Coronary intervention was the main treatment approach, although an invasive strategy was less frequent in nonagenarians in comparison to younger subjects. In-hospital mortality rate was 2-fold higher in the nonagenarians (5.6% vs. 2.5%, p = 0.025). Conclusion With increasing life expectancy, the prevalence of nonagenarians in ICCU’s is expected to increase. Although nonagenarian patients had more comorbidities and higher in-hospital mortality, they generally have good outcomes after admission to the ICCU. Hence, further studies to create evidence-based practices and to support and guide optimal management in these patients are warranted.

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Therapeutic management and outcome of nonagenarians versus octogenarians admitted to an intensive care unit for acute coronary syndromes

Cited by 6 publications

References 33 publications

Prevalence and Prognosis Impact of Frailty Among Older Adults in Cardiac Intensive Care Units

Prevalence and Prognosis Impact of Frailty Among Older Adults in Cardiac Intensive Care Units

Antithrombotic strategies in elderly patients with acute coronary syndrome

Nonagenarians admission and prognosis in a tertiary center intensive coronary care unit – a prospective study

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