Autor segons l'article: Pernias V; Garcia Acuna JM; Raposeiras-Roubin S; Barrabes JA; Cordero A; Martinez-Selles M; Bardaji A; Diez-Villanueva P; Marin F; Ruiz-Nodar JM; Vicente-Ibarra N; Alonso Salinas GL; Rigueiro P; Abu-Assi E; Formiga F; Nunez J; Nunez E; Ariza-Sole A; Sanchis J
Departament: Medicina i Cirurgia
Autor/s de la URV: Bardají Ruiz, Alfredo
Paraules clau: Elderly Coronary angiography Comorbidities Acute coronary syndrome
Resum: Introduction and objectives: The presence of comorbidities in elderly patients with non-ST-segment elevation acute coronary syndrome worsens its prognosis. The objective of the study was to analyze the impact of the burden of comorbidities in the decision of using invasive management in these patients. Methods: A total of 7211 patients > 70 years old from 11 Spanish registries were included. Individual data were analyzed in a common database. We assessed the presence of 6 comorbidities and their association with coronary angiography during admission. Results: The mean age was 79 ± 6 years and the mean CRACE score was 150 ± 21 points. A total of 1179 patients (16%) were treated conservatively. The presence of each comorbidity was associated with less invasive management (adjusted for predictive clinical variables): Cerebrovascular disease (OR, 0.78; 95%CI, 0.64-0.95; P = .01), anemia (OR, 0.64; 95%CI, 0.54-0.76; P < .0001), chronic kidney disease (OR, 0.65; 95%CI, 0.56-0.75; P < .0001), peripheral arterial disease (OR, 0.79; 95%CI, 0.65-0.96; P = .02), chronic lung disease (OR, 0.85; IC95%, 0.71-0.99; P = .05), and diabetes mellitus (OR, 0.85; 95%CI, 0.74-0.98; P < .03). The increase in the number of comorbidities (comorbidity burden) was associated with a reduction in coronary angiographies after adjusting for the GRACE score: 1 comorbidity (OR, 0.66; 95%CI, 0.54-0.81), 2 comorbidities (OR, 0.55; 95%CI, 0.45-0.69), 3 comorbidities (OR, 0.37; 95%CI, 0.29-0.47), 4 comorbidities (OR, 0.33; 95%CI, 0.24-0.45), ? 5 comorbidities (OR, 0.21; 95%CI, 0.12-0.36); all P values < .0001 compared to 0. Conclusions: The number of coronary angiographies performed drops as the number of comorbidities increases in elderly patients with non-ST-segment elevation acute coronary syndrome. More studies are still needed to know what the best management of these patients should be. © 2019 Permanyer Publications. All rights reserved.
Àrees temàtiques: Cardiology and cardiovascular medicine Cardiac & cardiovascular systems
Accès a la llicència d'ús: https://creativecommons.org/licenses/by/3.0/es/
ISSN: 2604-7322
Adreça de correu electrònic de l'autor: alfredo.bardaji@urv.cat
Identificador de l'autor: 0000-0003-1900-6974
Data d'alta del registre: 2024-07-27
Versió de l'article dipositat: info:eu-repo/semantics/publishedVersion
Enllaç font original: https://recintervcardiol.org/en/ischemic-heart-disease/impact-of-comorbidities-in-the-decision-of-using-invasive-management-in-elderly-patients-with-nsteacs
URL Document de llicència: https://repositori.urv.cat/ca/proteccio-de-dades/
Referència a l'article segons font original: Rec Interventional Cardiology. 3 (1): 15-20
Referència de l'ítem segons les normes APA: Pernias V; Garcia Acuna JM; Raposeiras-Roubin S; Barrabes JA; Cordero A; Martinez-Selles M; Bardaji A; Diez-Villanueva P; Marin F; Ruiz-Nodar JM; Vice (2021). Impact of comorbidities in the decision of using invasive management in elderly patients with NSTEACS. Rec Interventional Cardiology, 3(1), 15-20. DOI: 10.24875/RECICE.M20000147
DOI de l'article: 10.24875/RECICE.M20000147
Entitat: Universitat Rovira i Virgili
Any de publicació de la revista: 2021
Tipus de publicació: Journal Publications
Repositori URV