Şişli Hamidiye Etfal Education and Research Hospital, Department of Cardiology, Cardiologist, Turkey.
Arch Gerontol Geriatr. 2018 May-Jun;76:48-53. doi: 10.1016/j.archger.2018.01.012. Epub 2018 Feb 10.
The prevalence of coronary artery disease is on the rise as the life expectancy of the population increases. However, treatment of acute coronary syndrome in the elderly patients has its own problems that have not been thoroughly addressed in the clinical trials. Since these patients are generally fragile and have multiple co-morbidities, the course of acute coronary syndrome can frequently be complicated. Infection, which co-exists either at the initial presentation or is acquired during the hospital stay, is a condition about which there is little published data. Therefore, in our study, we wanted to assess the impact of infection on mortality in octogenarians who have acute coronary syndrome METHODS: We retrospectively analyzed the data of 174 octogenarians who had been admitted to the coronary care unit with acute coronary syndrome. All-cause mortality was defined as the primary endpoint of the study.
Overall 53 octogenarian patients (30.5%) had an infection along with acute coronary syndrome. The mean duration of follow-up was 10 months (1-25 months). Both in-hospital and long-term mortality were higher in these patients (18.9% vs 6.6%, p = 0.01; 52.8% vs 27.5%, p < 0.01; respectively). Kaplan-Meier analysis also showed lower cumulative survival. (p [log-rank] = 0.002). In multivariate Cox regression analysis; undergoing coronary angiography, infection (HR 1.96, 95% CI 1.15-3.34, p = 0.01), left ventricular ejection fraction and maximum C reactive protein levels were found as independent predictors of long-term survival.
Infection in octogenarians who were admitted due to acute coronary syndrome was frequent and increased their mortality substantially.
随着人口预期寿命的增加，冠心病的患病率呈上升趋势。然而，在临床试验中，老年患者急性冠状动脉综合征的治疗存在自身问题，尚未得到彻底解决。由于这些患者通常体质较弱，合并多种合并症，因此急性冠状动脉综合征的病程经常会变得复杂。感染是一种在发病初期或住院期间发生的并存疾病，关于这种疾病的临床数据很少。因此，在我们的研究中，我们想评估感染对患有急性冠状动脉综合征的 80 岁以上患者死亡率的影响。
我们回顾性分析了 174 名因急性冠状动脉综合征入住冠心病监护病房的 80 岁以上患者的数据。全因死亡率被定义为研究的主要终点。
共有 53 名 80 岁以上的患者（30.5%）患有急性冠状动脉综合征合并感染。平均随访时间为 10 个月（1-25 个月）。这些患者的住院和长期死亡率都较高（18.9%比 6.6%，p=0.01；52.8%比 27.5%，p<0.01）。Kaplan-Meier 分析也显示累积生存率较低。（p[log-rank]=0.002）。多变量 Cox 回归分析显示，进行冠状动脉造影、感染（HR 1.96，95%CI 1.15-3.34，p=0.01）、左心室射血分数和最大 C 反应蛋白水平是长期生存的独立预测因素。
因急性冠状动脉综合征住院的 80 岁以上患者感染频繁，死亡率显著增加。
