Articles producció científica> Medicina i Cirurgia

Impact of comorbidities in the decision of using invasive management in elderly patients with NSTEACS

  • Identification data

    Identifier: imarina:9242142
    Handle: https://hdl.handle.net/20.500.11797/imarina9242142
    Authors:
    Pernias VGarcia Acuna JMRaposeiras-Roubin SBarrabes JACordero AMartinez-Selles MBardaji ADiez-Villanueva PMarin FRuiz-Nodar JMVicente-Ibarra NAlonso Salinas GLRigueiro PAbu-Assi EFormiga FNunez JNunez EAriza-Sole ASanchis J
    Abstract:
    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. Mor

  • Others:

    Author, as appears in the 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
    Department: Medicina i Cirurgia
    URV's Author/s: Bardají Ruiz, Alfredo
    Keywords: Elderly Coronary angiography Comorbidities Acute coronary syndrome
    Abstract: 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.
    Thematic Areas: Cardiology and cardiovascular medicine Cardiac & cardiovascular systems
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    ISSN: 2604-7322
    Author's mail: alfredo.bardaji@urv.cat
    Author identifier: 0000-0003-1900-6974
    Record's date: 2024-07-27
    Papper version: info:eu-repo/semantics/publishedVersion
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Papper original source: Rec Interventional Cardiology. 3 (1): 15-20
    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
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2021
    Publication Type: Journal Publications

  • Keywords:

    Cardiac & Cardiovascular Systems,Cardiology and Cardiovascular Medicine
    Elderly
    Coronary angiography
    Comorbidities
    Acute coronary syndrome
    Cardiology and cardiovascular medicine
    Cardiac & cardiovascular systems

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