title: Long-term major adverse cardiovascular events and quality of life after coronary angiography in elderly patients with acute coronary syndrome.
abstract: BACKGROUND
  Although the elderly comprise the majority of acute coronary syndrome (ACS) patients, limited data exist on major adverse cardiovascular events (MACEs) and quality of life (QoL).
  
  
  OBJECTIVE
  To study MACEs and QoL prospectively in ACS patients >70years referred for coronary angiography.
  
  
  METHODS
  A prospective observational study that included ACS patients >70years undergoing coronary angiography. The outcomes were MACEs and QoL 3years after inclusion. MACEs were defined as death, recurrent ACS, new-onset of heart failure and repeated revascularization by coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). A QoL questionnaire was completed by the patients along with a physical examination and a personal interview at the 3-year follow-up. Multivariate analysis was performed to identify the predictors for MACEs.
  
  
  RESULTS
  In total, 138 patients (mean age 78.8±3.8years) with ACS were included in the study. Mean follow-up was 1196±296days. In all, 42% of the patients had MACEs and 25% had post-ACS heart failure. The mortality rate was 11%. After adjusting for significant cardiovascular risk factors, the following factors were significantly associated with MACEs: Age, high-sensitive troponin T (hsTNT), use of diuretics and reduced left ventricular ejection fraction (LVEF). Furthermore, the QoL evaluated with SF-36 in survivors from ACS at the end of study was similar to the QoL in an age-matched healthy Swedish population.
  
  
  CONCLUSIONS
  In this prospective study on elderly ACS patients MACEs still occurred in 42% of the cases (despite low mortality and good QoL), with post-ACS heart failure as the most important event.
authors: Department of Cardiology, Sahlgrenska University Hospital/Sahlgrenska, Gothenburg, Sweden; Department of Clinical and Molecular Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Electronic address: Runa.sigurjonsdottir@vgregion.se.
authors: R
authors: R
authors: Sigurjonsdottir
authors: Section of Cardiology, Department of Medicine, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden; Department of Clinical and Molecular Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors: S
authors: S
authors: Barywani
authors: Department of Cardiology, Sahlgrenska University Hospital/Sahlgrenska, Gothenburg, Sweden; Department of Clinical and Molecular Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors: P
authors: P
authors: Albertsson
authors: Section of Cardiology, Department of Medicine, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden; Department of Clinical and Molecular Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors: M
authors: M
authors: Fu
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000628:therapy; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D017023:Coronary Angiography / Q000009:adverse effects* / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life
keywords: Acute coronary syndrome; Elderly; MACEs; Post-ACS heart failure; Quality of life