title: One-year outcome following coronary angiography in elderly patients with non-ST elevation myocardial infarction:  real-world data from the Acute Coronary Syndromes Israeli Survey (ACSIS).
abstract: OBJECTIVE
  We aimed to evaluate the management and outcomes of patients of the octogenarian age group with non-ST elevation myocardial infarction (NSTEMI) in a real-world setting.
  
  
  METHODS
  The risk of 30-day and 1-year mortality by age and the time of coronary angiography [categorized as early (≤48 h of admission) and late (>48 h of admission)] was assessed among 2021 NSTEMI patients enrolled in the Acute Coronary Syndrome Israeli Survey (ACSIS) between 2004 and 2008.
  
  
  RESULTS
  Elderly patients (≥80 years) comprised almost 20% of the study population, and experienced a significantly higher rate of in-hospital complications. The risk of 1-year mortality was 3.4-fold (P<0.001) higher among octogenarian patients compared with younger patients. Multivariate analysis showed that among patients aged at least 80 years, utilization of revascularization was associated with a lower risk of death at 1 year [hazard ratio (HR)=0.50, P=0.004], but not at 30 days, compared with no angiography. However, referral for early coronary angiography was associated with a lower risk of death both at 30 days and at 1 year (HR=0.4, P=0.04 and HR=0.38, P=0.02, respectively).
  
  
  CONCLUSIONS
  Our findings indicate that patients of the octogenarian age group comprise a high-risk subset of the NSTEMI population, in whom early referral for coronary angiography is independently associated with a lower risk of mortality at 30 days and 1 year.
authors.affiliation: Sheba Medical Center and the Neufeld Cardiac Research Institute, Leviev Heart Institute, Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel. yonibuber@gmail.com
authors.forename: Jonathan
authors.initials: J
authors.lastname: Buber
authors.forename: Ilan
authors.initials: I
authors.lastname: Goldenberg
authors.forename: Lizzie
authors.initials: L
authors.lastname: Kimron
authors.forename: Victor
authors.initials: V
authors.lastname: Guetta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000453:epidemiology; D004232:Diuretics / Q000627:therapeutic use; D004363:Drug Utilization; D005260:Female; D019538:Health Care Surveys; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D007557:Israel / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy*; D009204:Myocardial Revascularization; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012017:Referral and Consultation; D061665:Time-to-Treatment
chemical_list: D004232:Diuretics; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors