title: Age as a Prognostic Factor in Patients with Acute Coronary Syndrome undergoing Urgent/Emergency Cardiac Surgery.
abstract: BACKGROUND
  Patients presenting with acute coronary syndrome (ACS) who require urgent/emergency coronary artery bypass grafting (CABG) are increasing, as is the complexity of their clinical characteristics, one of which is advanced age. We evaluated the prognostic role of age in patients undergoing urgent/emergency cardiac surgery for ACS.
  
  
  METHODS
  From January to December 2013, 452 consecutive patients underwent CABG at our institution. Among these, 213 presented with ACS, were enrolled in the study and divided into tertiles of age: First: 40-65 years old (n=73), Second: 66-74 (n=70), Third: 75-89 (n=70). Patients were followed post-operatively for 30 days.
  
  
  RESULTS
  No differences between tertiles were found for baseline clinical and angiographic characteristics. Off-pump interventions were 67.6%. Older patients more frequently required an associate intervention to CABG for a mechanical complication of ACS. Overall 30-day all-cause mortality was 4.7% (n=10); 0.6% (n=1) in patients undergoing isolated CABG (n=168, 78.9%). The STEMI diagnosis was an independent risk factor for 30-day mortality, and age was not.
  
  
  CONCLUSIONS
  The 30-day mortality rate of older ACS patients who undergo urgent/emergency CABG is comparable to that of younger ones. Pre-operative risk assessment should rely on evaluation of the clinical complexity of each patient independent of their chronological age, to customise the therapeutic strategy.
authors.affiliation: Heart and Vessel Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy. Electronic address: elena.crudeli@gmail.com.
authors.forename: Elena
authors.initials: E
authors.lastname: Crudeli
authors.affiliation: Heart and Vessel Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Lazzeri
authors.affiliation: Heart and Vessel Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Stefàno
authors.affiliation: Heart and Vessel Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Chiostri
authors.affiliation: Heart and Vessel Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Blanzola
authors.affiliation: Heart and Vessel Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Rossi
authors.affiliation: Heart and Vessel Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Olivo
authors.affiliation: Heart and Vessel Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
authors.forename: Stefano Del
authors.initials: SD
authors.lastname: Pace
authors.affiliation: Heart and Vessel Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Gensini
authors.affiliation: Heart and Vessel Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
authors.forename: Serafina
authors.initials: S
authors.lastname: Valente
mesh_terms: D054058:Acute Coronary Syndrome / Q000401:mortality* / Q000601:surgery*; D000328:Adult; D000367:Age Factors; D000368:Aged; D001026:Coronary Artery Bypass; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015996:Survival Rate
keywords: Acute coronary syndrome; Age; Elderly patient; Emergency revascularisation; Prognostic factor; Urgent coronary artery bypass grafting