Leviev Heart Center, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Cardiology Department, Rabin Medical Center, Petah Tiqva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Int J Cardiol. 2019 Apr 15;281:22-27. doi: 10.1016/j.ijcard.2019.01.076. Epub 2019 Jan 27.
While women ≥80 years old have a high prevalence of coronary artery disease (CAD), little data exist regarding their outcome following acute coronary syndrome (ACS).
In a retrospective study based on data of 3518 ACS women patients who were enrolled in the ACS Israel Survey (ACSIS), we first evaluated and compared the clinical outcomes of 858 ACS women ≥80 years with 2660 ACS women <80 years, hospitalized during 2000-2016. Secondly, we evaluated the clinical outcome of 450 women ≥80 years hospitalized during 2000-2006 ('early period') and compared them with 408 ACS women of the same age group hospitalized during 2008-2016 ('late period').
Implementation of the ACS AHA/ACC/ESC therapeutic guidelines was lower in ACS women ≥80 years compared with women <80 years. Multivariate Cox regression analysis demonstrated a worse 1-year survival rate in the ACS women ≥80 years compared with those <80 years. During the late period women ≥80 years were treated more frequently with guideline-recommended therapies compared with patients from the same age group who were hospitalized in the early period. A significant decline in in-hospital mortality rates in ACS women ≥80 years hospitalized in the late compared with the early period was demonstrated. However, 7-day, 30-day and 1-year mortality rates were not significantly changed.
Adverse outcome rates of ACS women ≥80 years were significantly higher compared with those <80 years. In-hospital survival rates of ACS women patients ≥80 years improved during the 2000-2016 period; however, long-term survival rates were not significantly changed.
虽然≥80 岁的女性患冠状动脉疾病（CAD）的患病率很高，但关于她们在急性冠状动脉综合征（ACS）后的结局的数据却很少。
在一项基于 2000-2016 年期间纳入 ACS 以色列调查（ACSIS）的 3518 例 ACS 女性患者数据的回顾性研究中，我们首先评估和比较了 858 例≥80 岁的 ACS 女性与 2660 例<80 岁的 ACS 女性的临床结局。其次，我们评估了 2000-2006 年期间（“早期”）住院的 450 例≥80 岁的女性患者的临床结局，并将其与 2008-2016 年期间（“晚期”）相同年龄组的 408 例 ACS 女性进行比较。
与<80 岁的女性相比，≥80 岁的 ACS 女性实施 ACS AHA/ACC/ESC 治疗指南的比例较低。多变量 Cox 回归分析表明，≥80 岁的 ACS 女性 1 年生存率较差。在晚期，与同一年龄组在早期住院的患者相比，≥80 岁的女性更多地接受了指南推荐的治疗。与早期相比，晚期≥80 岁的 ACS 女性的住院死亡率显著下降。然而，7 天、30 天和 1 年的死亡率没有明显变化。
与<80 岁的女性相比，≥80 岁的 ACS 女性的不良结局发生率明显更高。在 2000-2016 年期间，≥80 岁的 ACS 女性患者的住院生存率有所提高，但长期生存率没有明显变化。
