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[Multimorbidity in elderly patients with acute coronary syndrome: insights from BleeMACS registry].
Yan, Y; Gong, W; Wang, X; Fang, J Y; Nie, S P.
Afiliação
  • Yan Y; Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
  • Gong W; Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
  • Wang X; Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
  • Fang JY; Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
  • Nie SP; Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Zhonghua Xin Xue Guan Bing Za Zhi ; 50(5): 443-449, 2022 May 24.
Article em Zh | MEDLINE | ID: mdl-35589592
ABSTRACT

Objective:

To assess the prevalence, pattern and outcome of multimorbidity in elderly patients with acute coronary syndrome (ACS).

Methods:

Secondary analysis was performed based on the data from the BleeMACS registry, which was conducted between 2003 and 2014. We stratified elderly patients (≥65 years) according to their multimorbidity. Multimorbidity was defined as two or more chronic diseases in the same individual. Kaplan-Meier methods were used to estimate 1 year event rates for each endpoint, and comparisons between the study groups were performed using the log-rank test. The primary endpoint was net adverse clinical events (NACE), which is a composite of all-cause mortality, myocardial infarction, or bleeding.

Results:

Of 7 120 evaluable patients, 6 391 (89.8%) were with morbidity (1 594 with 1, 2 156 with 2, and 2 641 with ≥3 morbidity). Patients with morbidity were older, percent of female sex and non-ST-elevation acute coronary syndromes and implantation rate with drug-eluting stents and blood creatine level were higher compared to patients without morbidity. Compared with the patients without morbidity, the proportion of participants with oral anticoagulant increased in proportion to increased number of morbidities (5.8% vs. 6.4% with 1 morbidity, 7.3% with 2 morbidities, 9.0% with ≥3 morbidities, P trend<0.01) and the proportion of participants with clopidogrel prescription decreased in proportion to increased number of morbidity (91.9% vs. 89.7% with 1 morbidity, 87.9% with 2 morbidities, 88.6% with ≥3 morbidities, P trend = 0.01). During 1 year follow-up, compared with those with no morbidity, the hazard ratio (HR) and 95% confidence interval (CI) of risk of NACE for those with 1, 2, and ≥ 3 morbidities was 1.18 (0.86-1.64), 1.49 (1.10-2.02), and 2.74 (2.06-3.66), respectively (P < 0.01). Multimorbidity was not associated with an increased risk of bleeding of various organs (P>0.05).

Conclusion:

Multimorbidity is common in elderly patients with ACS. These patients might benefit from coordinated and integrated multimorbidity management by multidisciplinary teams.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Síndrome Coronariana Aguda / Intervenção Coronária Percutânea Tipo de estudo: Risk_factors_studies Limite: Aged / Female / Humans Idioma: Zh Revista: Zhonghua Xin Xue Guan Bing Za Zhi Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Síndrome Coronariana Aguda / Intervenção Coronária Percutânea Tipo de estudo: Risk_factors_studies Limite: Aged / Female / Humans Idioma: Zh Revista: Zhonghua Xin Xue Guan Bing Za Zhi Ano de publicação: 2022 Tipo de documento: Article