Brief reportPrognostic Value of Geriatric Conditions Beyond Age After Acute Coronary Syndrome
Section snippets
Patients and Methods
This was a prospective cohort design including 342 consecutive patients (from October 1, 2010, to February 1, 2012), survivors of acute coronary syndrome, from the Cardiology Department of the University Clinic Hospital in Valencia, Spain. A detailed description of the study design has been explained elsewhere.4 In brief, inclusion criteria were admission for acute coronary syndrome (either ST-segment elevation or non–ST-segment elevation acute coronary syndrome), older than 65 years, and
Baseline Characteristics
The baseline characteristics of the patients are presented in Supplemental Table 1. The mean age was 77.5±7.1 years. Seventy-two patients (21%) had ST-segment elevation acute myocardial infarction; 25 of them (35%) were treated with primary coronary angioplasty, whereas 24 (33%) received fibrinolytic treatment. On the other hand, 213 of 270 patients with non–ST-segment elevation acute coronary syndrome (80%) underwent a coronary angiogram during hospitalization. The median length of stay was 6
Discussion
The present study analyzed the long-term prognostic value of geriatric conditions beyond age after acute coronary syndrome. The main finding was that frailty and comorbidity provided significant incremental prognostic information and reclassified the risk of all-cause mortality beyond what age alone can do. Therefore, risk stratification after acute coronary syndrome needs to consider not only age but also frailty and comorbidity.
Age is a well-known predictive factor for all-cause mortality
Conclusion
Frailty and comorbidity are more important mortality predictors than is age after acute coronary syndrome. Indeed, they significantly reclassify the risk beyond what age alone can do. Therefore, frailty and comorbidity need to be incorporated into risk assessment after acute coronary syndrome.
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Cited by (0)
Grant Support: The work was supported by the Spanish Ministry of Economy and Competitiveness through the Carlos III Health Institute (grant nos. RD12/0042/0010, CB16/11/00420, and FIS 15/00837), Fondo Europeo de Desarrollo Regional, and Health Research Fund.