Department of Geriatrics & Gerontology, University of Medicine and Pharmacy in Ho Chi Minh City, Ho Chi Minh City, Vietnam.
Department of Interventional Cardiology, Thong Nhat Hospital, Ho Chi Minh City, Vietnam.
PLoS One. 2020 Jun 15;15(6):e0233272. doi: 10.1371/journal.pone.0233272. eCollection 2020.
There is limited evidence of non-ST elevation acute coronary syndrome (NSTE-ACS) in patients aged 80 or older in Vietnam.
To describe the clinical characteristics of patients aged≥80 with NSTE-ACS in Vietnam, and to examine the effect of percutaneous coronary intervention (PCI) on adverse outcomes.
Consecutive patients aged ≥80 with a diagnosis of NSTE-ACS admitted to two tertiary hospitals in Vietnam from 12/2018 to 06/2019 were recruited. The major outcomes were: (1) the composite of all-cause mortality, recurrent myocardial infarction and stroke, (2) re-admission rate during 3 months. Cox proportional-hazards regressions were conducted to examine the impact of PCI on the study outcomes, with results presented as hazard ratios (HR) and 95% confidence intervals (CI).
There were 120 participants, mean age 84.8 ± 3.8, 50% were female. Angiography and PCI were performed in 42 participants (35.0%). Most of the participants had multimorbidity and multiple coronary vessel disease. Compared to participants who did not receive PCI, participants who received PCI had significantly lower rates of adverse events during hospitalisation and during 3 months of follow up. Cox proportional hazards models adjusted to age and GRACE score show that PCI was significantly associated with reduced the composite outcome of all-cause mortality, recurrent myocardial infarction and stroke during 3 months follow-up (adjusted HR 0.32, 95%CI 0.12-0.86). PCI was also associated with reduced re-admission.
The rate of PCI was low in the very elderly patients with NSTE-ACS in this study, although PCI was significantly associated with reduced adverse outcomes.
越南 80 岁及以上非 ST 段抬高型急性冠脉综合征（NSTE-ACS）患者的相关证据有限。
描述越南 80 岁及以上 NSTE-ACS 患者的临床特征，并探讨经皮冠状动脉介入治疗（PCI）对不良结局的影响。
连续纳入 2018 年 12 月至 2019 年 6 月期间在越南两家三级医院就诊的诊断为 NSTE-ACS 且年龄≥80 岁的患者。主要结局为：（1）全因死亡率、复发性心肌梗死和卒中的复合结局，（2）3 个月内再入院率。采用 Cox 比例风险回归分析评估 PCI 对研究结局的影响，结果以风险比（HR）和 95%置信区间（CI）表示。
共纳入 120 名患者，平均年龄 84.8±3.8 岁，50%为女性。42 名患者（35.0%）接受了血管造影和 PCI。大多数患者患有多种合并症和多支冠状动脉疾病。与未接受 PCI 的患者相比，接受 PCI 的患者住院期间和 3 个月随访期间不良事件的发生率显著降低。调整年龄和 GRACE 评分后的 Cox 比例风险模型显示，PCI 与 3 个月随访期间全因死亡率、复发性心肌梗死和卒中的复合结局显著降低相关（校正 HR 0.32，95%CI 0.12-0.86）。PCI 还与再入院率降低相关。
在这项研究中，NSTE-ACS 的非常老年患者的 PCI 率较低，但 PCI 与降低不良结局显著相关。
