Abstract:
Introduction:The clinical benefit of invasive therapy in elderly patients with acute coronary syndrome (ACS) remains unclear. Furthermore, the decision-making process to treat this growing patient group is also debatable. The purpose of this study was to assess the association between elderly ACS patients, the treatment choice and their in-hospital outcomes after non-ST-elevation (NSTE)-ACS in a consecutive series of patients >75 years of age. Methods and Results:Consecutive patients >75 years presenting with NSTE-ACS in our hospital between July 2017 and July 2018 were included during the first 2 days of hospital admission. Demographic data, prior medical history and present medical condition were documented. During day 0 and day 2, geriatric assessments (Clinical Frailty Scale [CFS], Barthel index, Charlson comorbidity index, "timed up and go" test [TUG], Mini-Mental Status Test [MMS], Geriatric Depression Scale [GDS], SF-36 for quality of life, instrumental activities of daily living [IADL], Killip-score, Grace-score and Euro-score) were conducted. After 6 months, patients were re-evaluated. In 106 patients (mean age 81.9±5.3 years, 57% male gender), 68 patients (64%) were treated interventionally, and 38 patients had conservative treatment (36%). Patients treated with intervention were significantly younger (80.9±4.7 years vs 83.5±6.0 years, p=0.015), had a lower rate of prior cerebral events (17.6% vs 26.3%; p=ns) and suffered more often from chronic obstructive pulmonary disease (17.6% vs 34.2%; p=0.050). All other demographic variables were comparable between both groups. The composite clinical endpoint (death, re-infarction, bleeding) was reached in 7 patients (10.3%) of the invasive and in 2 patients (5.3%) of the conservative group. They were not significantly different between both groups. A frailty index, consisting of commonly used parameters of functional impairment in elderly patients, namely, MMS ≤2 at baseline, IADL ≤7, CFS ≥7 and age ≥85 years, significantly predicted conservative treatment. Conclusion:Effective revascularization techniques are still underused in patients of older age in the case of ACS. For decision-making, geriatric tests alone may not predict treatment in those patients, but the combination of different tests may better predict treatment and perhaps the clinical outcomes in those patients. Furthermore, frail patients are at higher risk for not receiving guideline recommended therapy.
journal_name
Clin Interv Agingjournal_title
Clinical interventions in agingauthors
Rittger H,Stadelmaier C,Kieschnick T,Büber D,Rank K,Vitali-Serdoz L,Bastian D,Waliszewski Mdoi
10.2147/CIA.S249017subject
Has Abstractpub_date
2020-05-25 00:00:00pages
723-731eissn
1176-9092issn
1178-1998pii
249017journal_volume
15pub_type
杂志文章abstract::Cognitive frailty, defined as the coexistence of mild cognitive impairment symptoms and physical frailty phenotype in older persons, is increasingly considered the main geriatric condition predisposing to dementia. Recent studies have demonstrated that gut microbiota may be involved in frailty physiopathology by promo...
journal_title:Clinical interventions in aging
pub_type: 杂志文章,评审
doi:10.2147/CIA.S139163
更新日期:2018-08-29 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S160363
更新日期:2018-09-27 00:00:00
abstract:Background:Aging leads to structural and functional changes in the vasculature characterized by arterial endothelial dysfunction and stiffening of large elastic arteries and is a predominant risk factor for cardiovascular disease, the leading cause of morbidity and mortality in modern societies. Although exercise reduc...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S220283
更新日期:2019-09-02 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 杂志文章,meta分析
doi:10.2147/CIA.S210062
更新日期:2019-07-12 00:00:00
abstract:BACKGROUND:Delirium in hip fractured patients is a frequent complication. Dementia is an important risk factor for delirium and is common in frail elderly. This study aimed to extend the previous knowledge on risk factors for delirium and the consequences. Special attention was given to patients with dementia and delir...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S115945
更新日期:2017-03-10 00:00:00
abstract::Atrial fibrillation (AF) is associated with an increased incidence and severity of strokes. The burden of AF-related stroke is expected to increase in parallel with the aging of the population. Oral anticoagulation with warfarin has been the pharmacologic standard for stroke risk reduction in patients with AF. When us...
journal_title:Clinical interventions in aging
pub_type: 杂志文章,评审
doi:10.2147/CIA.S37818
更新日期:2013-01-01 00:00:00
abstract::In this case study of an unique instance, effects of medium-energy, high-focused extracorporeal generated shock waves (ESW) onto the skin and the underlying fat tissue of a cellulite afflicted, 50-year-old woman were investigated. The treatment consisted of four ESW applications within 21 days. Diagnostic high-resolut...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/cia.s2334
更新日期:2008-01-01 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 临床试验,杂志文章
doi:10.2147/CIA.S56532
更新日期:2014-02-12 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S65736
更新日期:2014-12-01 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S134205
更新日期:2017-07-04 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S53441
更新日期:2014-12-12 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S122352
更新日期:2017-01-06 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 杂志文章,随机对照试验
doi:10.2147/CIA.S94881
更新日期:2016-03-24 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S135364
更新日期:2017-05-26 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S178393
更新日期:2018-10-08 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S250321
更新日期:2020-08-18 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 杂志文章,meta分析
doi:10.2147/CIA.S91721
更新日期:2015-10-28 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 杂志文章,评审
doi:10.2147/CIA.S196944
更新日期:2020-09-15 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S45201
更新日期:2013-01-01 00:00:00
abstract::Bazedoxifene, a novel selective estrogen receptor modulator, has been developed to have favorable effects on bone and the lipid profile while minimizing stimulation of uterine or breast tissues. Two large Phase III clinical trials showed that bazedoxifene, as well as raloxifene, increased bone mineral density, decreas...
journal_title:Clinical interventions in aging
pub_type: 杂志文章,评审
doi:10.2147/CIA.S15711
更新日期:2011-01-01 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 临床试验,杂志文章,多中心研究
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更新日期:2017-12-14 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 杂志文章,评审
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更新日期:2014-01-15 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 杂志文章,评审
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更新日期:2007-01-01 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S151453
更新日期:2018-03-01 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S45900
更新日期:2013-01-01 00:00:00
abstract::In the elderly population, osteoporosis is a significant clinical problem leading to disability and even death. Many patients remain untreated, despite effective therapies, because of patients' unwillingness to take current therapies or inability to tolerate the therapies. For this reason, ongoing research continues t...
journal_title:Clinical interventions in aging
pub_type: 杂志文章,评审
doi:
更新日期:2007-01-01 00:00:00
abstract:PURPOSE:Postvertebral augmentation vertebral compression fractures are common; repeated vertebral augmentation is usually performed for prompt pain relief. This study aimed to evaluate the incidence and risk factors of repeat vertebral augmentation. METHODS:We performed a retrospective, nationwide, population-based lo...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S80668
更新日期:2015-03-27 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S228324
更新日期:2019-11-26 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 杂志文章
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更新日期:2014-10-13 00:00:00
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journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S192050
更新日期:2019-02-15 00:00:00