title: Correlation between comprehensive evaluation of coronary artery lesion severity and long-term clinical outcomes in Chinese octogenarians with acute coronary syndrome.
abstract: BACKGROUND
  There is little known about long-term outcome data regarding acute coronary syndrome (ACS) in Chinese octogenarians (> 80 years old). Long-term outcomes of octogenarians with ACS may be associated with increased complicated coronary artery lesion severity.
  
  
  METHODS
  We classified 536 consecutive octogenarians with ACS into four groups based on Gensini score. Survival and major adverse cardiac event (MACE) rates were calculated using the Kaplan-Meier method. Multivariate Cox regression was used to identify mortality predictors. The follow-up period was 27 (IQR15-36) months.
  
  
  RESULTS
  The overall long-term mortality rate was 9.1% and increased from 3.0% in group 1 to 16.7% in group 4. Increasing coronary artery lesion severity was associated with increased long-term mortality and MACE rates. ROC curve analysis showed that the predictive cut-off value of Gensini score for mortality was 53. Gensini score provided significant reclassification of mortality (net reclassification index 0.195, P<0.01). Age, gender, heart rate, SBP, chronic renal failure, e-GFR, GRACE score, Gensini score, and ACS type were different between surviving and deceased patients. Notably, chronic renal failure (OR=2.55, P=0.036), GRACE score (OR=1.10, P=0.006), and Gensini score(OR=1.11, P=0.003) were the independent predictors of long-term mortality.
  
  
  CONCLUSIONS
  Long-term mortality of octogenarians with ACS was associated with increased comprehensive coronary artery lesion severity. Gensini score was an effective parameter for evaluation of long-term mortality.
authors: Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China; Department of Cardiology, Hainai Branch of Chinese People's Liberation Army General Hospital, Sanya, Hainan, People's Republic of China.
authors: Zhenhong
authors: Z
authors: Fu
authors: Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China.
authors: Hao
authors: H
authors: Xue
authors: Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China. Electronic address: 301dongw@sina.com.
authors: Wei
authors: W
authors: Dong
authors: Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China.
authors: Lian
authors: L
authors: Chen
authors: Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China.
authors: Luyue
authors: L
authors: Gai
authors: Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China.
authors: Hongbin
authors: H
authors: Liu
authors: Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China.
authors: Zhijun
authors: Z
authors: Sun
authors: Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China.
authors: Jun
authors: J
authors: Guo
authors: Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China. Electronic address: cyundai@medmail.com.cn.
authors: Yundai
authors: Y
authors: Chen
mesh_terms: D054058:Acute Coronary Syndrome / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D003331:Coronary Vessels / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D008297:Male; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate
keywords: Acute coronary syndrome; Coronary artery stenosis; Octogenarians; Prognosis; Risk factors