Octogenarians died mainly of cardiovascular diseases five years after acute coronary syndrome.
OBJECTIVE
A substantial part of deaths and readmissions in octogenarians with acute coronary syndrome (ACS) is assumed to be of non-cardiovascular causes. However, limited data on cause-specific long-term mortality and hospital readmissions are available. This study was aimed to investigate 5-year cause-specific deaths and re-hospitalizations as well as their prognostic predictors among octogenarians with ACS managed with percutaneous coronary intervention (PCI).


METHODS
A total of 181 octogenarians managed with PCI on ACS indication during 2006-2007 at Sahlgrenska University Hospital were included. The time-period was chosen to allow a follow-up period of five years.


RESULTS
All-cause 5-year mortality was 46%. Approximately 70% of deaths were cardiovascular. All-cause hospital readmissions were 71%. The majority of readmissions were due to non-cardiovascular diseases, 61% of all readmissions. Cox proportional-hazard regression analyses for cardiovascular mortality identified female sex and culprit lesion in left coronary arteries as independent predictors. Negative binomial regression models showed female sex and complications during index hospitalization as independent predictors of increased cardiovascular re-hospitalizations and prior smoking as independent predictor of increased non-cardiovascular re-hospitalizations.


CONCLUSIONS
In an octogenarian cohort presented with ACS treated with PCI, cardiovascular diseases were the main causes of deaths, whereas non-cardiovascular diseases were the main causes of re-hospitalizations.
a Department of Molecular and Clinical Medicine , Sahlgrenska Academy, Sahlgrenska University Hospital (SU)/Östra Hospital, University of Gothenburg , Gothenburg , Sweden.
Salim Bary
SB
Barywani
b Department of Biostatistic , University of Gothenburg , Gothenburg , Sweden.
Max
M
Petzold
D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D000367:Age Factors; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000401:mortality*; D002423:Cause of Death; D016009:Chi-Square Distribution; D005260:Female; D017052:Hospital Mortality; D006785:Hospitals, University; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D010359:Patient Readmission; D062645:Percutaneous Coronary Intervention; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013548:Sweden; D013997:Time Factors; D016896:Treatment Outcome
Cause-specific; acute coronary syndrome; mortality; octogenarians; percutaneous coronary intervension; re-hospitalization