title: Cumulative incidence of death and rehospitalization among the elderly in the first year after NSTEMI.
abstract: BACKGROUND
  Age is associated with outcomes in non-ST-segment elevation myocardial infarction; however, less is known about rehospitalization or death among elderly survivors. We aimed to evaluate mortality and cause-specific rehospitalization rates in this growing population of older adults with ischemic heart disease.
  
  
  METHODS
  We linked 36,711 patients aged ≥65 years who survived an index non-ST-segment elevation myocardial infarction from the CRUSADE registry to Medicare claims data for follow-up. One-year survival estimates were compared by age group-65-79, 80-84, 85-89, and ≥90 years-and Cox models were used to analyze the association between age and 1-year mortality.
  
  
  RESULTS
  Death at 1 year increased markedly with age (from 13.3% for 65-79 years to 45.5% for ≥90 years). In contrast, rehospitalization rates at 1 year were similar and high across ages (65-79 years, 52.7%; ≥90 years, 56.5%), with nearly as many noncardiovascular-related as cardiovascular-related rehospitalizations. At 1 year, nonagenarians had substantially higher rates of death with or without preceding rehospitalization and twice the adjusted mortality than the group aged 65-79 years.
  
  
  CONCLUSIONS
  Evolving care delivery models should consider the high mortality in older adults after a non-ST-segment elevation myocardial infarction. Contrary to expectations, rehospitalization rates do not rise substantially with advancing age, and rehospitalization is often for noncardiac diagnoses.
authors: Duke Clinical Research Institute, Duke University Medical Center, Durham, NC. Electronic address: renato.lopes@duke.edu.
authors: Renato D
authors: RD
authors: Lopes
authors: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn.
authors: S Michael
authors: SM
authors: Gharacholou
authors: Duke Clinical Research Institute, Duke University Medical Center, Durham, NC.
authors: DaJuanicia N
authors: DN
authors: Holmes
authors: Duke Clinical Research Institute, Duke University Medical Center, Durham, NC.
authors: Laine
authors: L
authors: Thomas
authors: Duke Clinical Research Institute, Duke University Medical Center, Durham, NC.
authors: Tracy Y
authors: TY
authors: Wang
authors: Duke Clinical Research Institute, Duke University Medical Center, Durham, NC.
authors: Matthew T
authors: MT
authors: Roe
authors: Duke Clinical Research Institute, Duke University Medical Center, Durham, NC.
authors: Eric D
authors: ED
authors: Peterson
authors: Duke Clinical Research Institute, Duke University Medical Center, Durham, NC.
authors: Karen P
authors: KP
authors: Alexander
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology / Q000401:mortality*; D010359:Patient Readmission; D012042:Registries; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
keywords: Coronary disease; Death; Long-term outcomes; Myocardial infarction; Non-ST-segment elevation myocardial infarction; Rehospitalization