Cor Vasa 2018, 60(1):e66-e69 | DOI: 10.1016/j.crvasa.2017.02.007

Trends in the treatment and outcomes of elderly patients with acute coronary syndrome: Results from the CZECH registries

Klára Stašková^a, Petr Toušek^b,*, František Toušek^a, Anna Malá^b, Michael Želízko^c, David Horák^d, Martin Sluka^e, Alexandra Vodzinská^f, Radek Jančár^g, Michael Aschermann^h, Jiří Jarkovskýⁱ, Petr Widimský^b

^a Kardiologické oddělení, Nemocnice České Budějovice, a.s., České Budějovice, Česká republika

^b Kardiocentrum, 3. lékařská fakulta Univerzity Karlovy a Fakultní nemocnice Královské Vinohrady, Praha, Česká republika

^c Kardiocentrum, Institut klinické a experimentální medicíny, Praha, Česká republika

^d Kardiocentrum, Krajská nemocnice Liberec, Liberec, Česká republika

^e Kardiocenturm, Fakultní nemocnice Olomouc, Olomouc, Česká republika

^f Kardiocentrum, Nemocnice Podlesí, a.s., Třinec, Česká republika

^g Kardiologické oddělení, Městská nemocnice Ostrava, Ostrava, Česká republika

^h II. interní klinika kardiologie a angiologie, 1. lékařská fakulta Univerzity Karlovy a Všeobecná fakultní nemocnice v Praze, Praha, Česká republika

ⁱ Institut biostatistiky a analýz, Lékařská fakulta Masarykovy univerzity, Brno, Česká republika

Background: The number of elderly patients in the population is rapidly increasing, and little is known about how adherence to recommended treatment strategies in elderly patients with acute coronary syndrome (ACS) has changed over time.

Aim: To analyze trends in the treatment and outcomes of elderly patients with ACS from two registries conducted in the Czech Republic over 10 years.

Methods and results: Data from the CZECH-1 and CZECH-3 registries were used in this study. These registries collected data in autumn 2005 and autumn 2015, and contain data from 1952 and 1754 unselected patients, respectively. All patients had been hospitalized with an initial diagnosis of ACS. There were 490 (25.7%) elderly patients in the CZECH-1 registry and 484 (28.1%) elderly patients in the CZECH-3 registry (p = 0.045) with an average age of 80.6 ± 4 and 82.1 ± 5 years (p < 0.001), respectively. ACS was confirmed in 345 (72%) and 352 (73.6%) elderly patients (p = 0.781), respectively. There was higher use of percutaneous coronary intervention (65.2% and 54.8%; p < 0.001), dual antiplatelet treatment, ACE inhibitors, and statins during treatment in the CZECH-3 compared to the CZECH-1 registry. No differences in hospital mortality of elderly patients with confirmed ACS were observed between registries (8.2% vs. 10.4%; p = 0.790).

Conclusion: The proportion of patients with ACS that are elderly is increasing along with their increasing average age. Adherence to guideline-recommended therapy in this sub-group of patients has improved over time, but hospital mortality remains unchanged.

Keywords: Acute coronary syndrome; Elderly; Outcome; Treatment strategy

Received: January 17, 2017; Accepted: February 25, 2017; Published: February 1, 2018  Show citation