RESUMO
A prospective study was performed in 177 patients, mean age 78+/-6 years, hospitalized with acute coronary syndromes. Obstructive coronary artery disease was documented by coronary angiography in 154 of 177 patients (87%). Coronary revascularization was performed in 96 of 177 patients (54%). Five of 177 patients (3%) died during hospitalization. Compared to use before hospitalization, at hospital discharge the use of aspirin increased from 43% to 84% (p<0.001), the use of clopidogrel increased from 21% to 54% (p<0.001), the use of beta blockers increased from 38% to 76% (p<0.001), the use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers increased from 42% to 70% (p<0.001), the use of long-acting nitrates increased from 15% to 31% (p<0.001), and the use of calcium channel blockers decreased from 28% to 23% (p=NS). Dyslipidemia was present in 62% of the 177 patients. The use of statins increased from 34% before hospitalization to 63% at hospital discharge (p<0.001).
Assuntos
Fármacos Cardiovasculares/administração & dosagem , Doença das Coronárias/tratamento farmacológico , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Inibidores da Enzima Conversora de Angiotensina/administração & dosagem , Aspirina/administração & dosagem , Bloqueadores dos Canais de Cálcio/administração & dosagem , Angiografia Coronária , Doença das Coronárias/diagnóstico por imagem , Doença das Coronárias/mortalidade , Doença das Coronárias/cirurgia , Uso de Medicamentos , Feminino , Hospitalização , Humanos , Masculino , Revascularização Miocárdica , Alta do Paciente , Probabilidade , Prognóstico , Estudos Prospectivos , Índice de Gravidade de Doença , Taxa de SobrevidaAssuntos
Doença da Artéria Coronariana/epidemiologia , Reperfusão Miocárdica/estatística & dados numéricos , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/etiologia , Doença da Artéria Coronariana/patologia , Doença da Artéria Coronariana/terapia , Feminino , Serviços de Saúde para Idosos/estatística & dados numéricos , Mortalidade Hospitalar , Humanos , Incidência , Masculino , New York/epidemiologia , Prevalência , Estudos Prospectivos , Recidiva , Fatores de Risco , Fatores Sexuais , Síndrome , Saúde da MulherRESUMO
The purpose of this study was to investigate acute coronary syndromes (ACS) in elderly persons of different races. A prospective study was performed in which 177 consecutive unselected patients aged > or = 70 years hospitalized for ACS had coronary angiography. The patients included 11 blacks, 140 whites, and 26 patients of other races. Obstructive coronary artery disease (CAD) was present in 8 of 11 blacks (73%), 121 of 140 whites (86%), and 25 of 26 patients of other races (96%) (P < 0.05 comparing black patients with those of other races). Left main CAD was present in 0 of 11 blacks (0%), 9 of 140 whites (6%), and in 1 of 26 patients of other races (4%) (P not significant). Left anterior descending or diagonal CAD was present in 4 of 11 blacks (36%), 96 of 140 whites (67%), and 18 of 26 patients of other races (69%) (P < 0.05 comparing blacks with whites). Left circumflex or obtuse marginal disease was present in 5 of 11 blacks (45%), 72 of 140 whites (51%), and in 17 of 26 patients of other races (65%) (P not significant). Right CAD was present in 5 of 11 blacks (45%), 81 of 140 whites (58%), and 18 of 26 patients of other races (69%) (P not significant). Coronary revascularization was performed in 7 of 11 blacks (64%), 72 of 140 whites (52%), and 17 of 26 patients of other races (66%) (P not significant).