PMID- 34942303 OWN - NLM STAT- MEDLINE DCOM- 20220314 LR - 20220501 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 351 DP - 2022 Mar 15 TI - Early angiography in elderly patients with non-ST-segment elevation acute coronary syndrome: The cardio CHUS-HUSJ registry. PG - 8-14 LID - S0167-5273(21)02031-3 [pii] LID - 10.1016/j.ijcard.2021.12.028 [doi] AB - BACKGROUND: In elderly patients with non-ST elevation acute coronary syndrome (NSTEACS), while routine invasive management is established in high-risk NSTEACS patients, there is still uncertainty regarding the optimal timing of the procedure. METHODS: This study analyzes the association of early coronary angiography with all-cause mortality, cardiovascular mortality, heart failure (HF) hospitalization, and major adverse cardiovascular events (MACE) in patients older than 75 years old with NSTEACS. This retrospective observational study included 7811 consecutive NSTEACS patients who were examined between the years 2003 and 2017 at two Spanish university hospitals. There were 2290 patients older than 75 years old. We compared their baseline characteristics according to the early invasive strategy used (coronarography 24 h) after the diagnosis of NSTEACS. RESULTS: Among the study participants, 1566 patients (68.38%) underwent early invasive coronary intervention. The mean follow-up period was 46 months (interquartile range 18-71 months). This association was also maintained after propensity score matching: early invasive strategy was significantly related to lower all-cause mortality [HR 0.61 (95% CI 0.51-0.71)], cardiovascular mortality [HR 0.52 (95% CI 0.43-0.63)], and MACE [HR 0.62 (CI 95% 0.54-0.71)]. CONCUSIONS: In a contemporary real-world registry of elderly NSTEACS patients, early invasive management significantly reduced all-cause mortality, cardiovascular mortality, and MACE during long-term follow-up. BRIEF SUMMARY: In this real-world retrospective observational study that included 2451 patients older than 75 years old, 1566 patients (68.38%) underwent early invasive coronary intervention. After performing a propensity score matching, the early invasive strategy was still associated with lower all-cause mortality [HR (hazard ratio) 0.61, 95% CI (95% confidence interval) (0.51-0.71)], cardiovascular mortality [HR 0.52 (95%CI 0.43-0.63)], and MACE [HR 0.62 (95%CI 0.54-0.71)] during long-term follow-up. CI - Copyright (c) 2021 Elsevier B.V. All rights reserved. FAU - Gonzalez Ferrero, Teba AU - Gonzalez Ferrero T AD - Cardiology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV). Electronic address: tebagf@gmail.com. FAU - Alvarez Alvarez, Belen AU - Alvarez Alvarez B AD - Cardiology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV). FAU - Cordero, Alberto AU - Cordero A AD - Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV); Cardiology Department, University Hospital of San Juan, Alicante. Spain. FAU - Martinon Martinez, Jesus AU - Martinon Martinez J AD - Cardiology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain. FAU - Cacho Antonio, Carla AU - Cacho Antonio C AD - Cardiology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV). FAU - Sestayo-Fernandez, Manuela AU - Sestayo-Fernandez M AD - Cardiology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV). FAU - Bouzas-Cruz, Noelia AU - Bouzas-Cruz N AD - Cardiology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV). FAU - Antunez Muinos, Pablo AU - Antunez Muinos P AD - Cardiology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV). FAU - Casas, Charigan Abou Jokh AU - Casas CAJ AD - Cardiology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV). FAU - Otero Garcia, Oscar AU - Otero Garcia O AD - Cardiology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV). FAU - Arias, Federico Garcia-Rodeja AU - Arias FG AD - Cardiology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV). FAU - Perez Dominguez, Marta AU - Perez Dominguez M AD - Cardiology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV). FAU - Torrelles Fortuny, Abel AU - Torrelles Fortuny A AD - Cardiology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV). FAU - Iglesias Alvarez, Diego AU - Iglesias Alvarez D AD - Cardiology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV). FAU - Agra Bermejo, Rosa AU - Agra Bermejo R AD - Cardiology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV). FAU - Rigueiro Veloso, Pedro AU - Rigueiro Veloso P AD - Cardiology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV). FAU - Cid Alvarez, Belen AU - Cid Alvarez B AD - Cardiology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV). FAU - Garcia Acuna, Jose Maria AU - Garcia Acuna JM AD - Cardiology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV). FAU - Zuazola, Pilar AU - Zuazola P AD - Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV); Cardiology Department, University Hospital of San Juan, Alicante. Spain. FAU - Escribano, David AU - Escribano D AD - Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV); Cardiology Department, University Hospital of San Juan, Alicante. Spain. FAU - Lage, Ricardo AU - Lage R AD - Cardiology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV). FAU - Gude Sampedro, Francisco AU - Gude Sampedro F AD - Epidemiology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain. FAU - Gonzalez Juanatey, Jose Ramon AU - Gonzalez Juanatey JR AD - Cardiology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV). LA - eng PT - Journal Article PT - Observational Study DEP - 20211221 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM MH - *Acute Coronary Syndrome/diagnostic imaging/surgery MH - Aged MH - Coronary Angiography/methods MH - Humans MH - *Percutaneous Coronary Intervention/methods MH - Registries MH - Retrospective Studies MH - Risk Factors MH - Treatment Outcome EDAT- 2021/12/24 06:00 MHDA- 2022/03/15 06:00 CRDT- 2021/12/23 20:14 PHST- 2021/07/16 00:00 [received] PHST- 2021/11/08 00:00 [revised] PHST- 2021/12/17 00:00 [accepted] PHST- 2021/12/24 06:00 [pubmed] PHST- 2022/03/15 06:00 [medline] PHST- 2021/12/23 20:14 [entrez] AID - S0167-5273(21)02031-3 [pii] AID - 10.1016/j.ijcard.2021.12.028 [doi] PST - ppublish SO - Int J Cardiol. 2022 Mar 15;351:8-14. doi: 10.1016/j.ijcard.2021.12.028. Epub 2021 Dec 21.