Skip to main content
Journal cover image

Impact of age on management and outcome of acute coronary syndrome: observations from the Global Registry of Acute Coronary Events (GRACE).

Publication ,  Journal Article
Avezum, A; Makdisse, M; Spencer, F; Gore, JM; Fox, KAA; Montalescot, G; Eagle, KA; White, K; Mehta, RH; Knobel, E; Collet, J-P; GRACE Investigators,
Published in: Am Heart J
January 2005

BACKGROUND: Evidence-based cardiac therapies are underutilized in elderly patients. We assessed differences in practice patterns, comorbidities, and in-hospital event rates, by age and type of acute coronary syndrome (ACS). METHODS: We studied 24165 ACS patients in 102 hospitals in 14 countries stratified by age. RESULTS: Approximately two-thirds of patients were men, but this proportion decreased with age. In elderly patients (> or = 65 years), history of angina, transient ischemic attack/stroke, myocardial infarction(MI), congestive heart failure, coronary artery bypass graft (CABG) surgery, hypertension or atrial fibrillation were more common, and delay in seeking medical attention and non-ST-segment elevation MI were significantly higher. Aspirin, beta-blockers, thrombolytic therapy, statins and glycoprotein IIb/IIIa inhibitors were prescribed less, while calcium antagonists and angiotensin-converting enzyme inhibitors were prescribed more often to elderly patients. Unfractionated heparin was prescribed more often in young patients, while low-molecular-weight heparins were similarly prescribed across all age groups. Coronary angiography and percutaneous intervention rates significantly decreased with age. The rate of CABG surgery was highest among patients aged 65-74 years (8.1%) and 55-64 years (7.7%), but reduced in the youngest (4.7%) and oldest (2.7%) groups. Major bleeding rates were 2-3% among patients aged < 65 years, and > 6% in those > or = 85 years. Hospital-mortality rates, adjusted for baseline risk differences, increased with age (odds ratio: 15.7 in patients > or = 85 years compared with those < 45 years). CONCLUSIONS: Many elderly ACS patients do not receive evidence-based therapies, highlighting the need for clinical trials targeted specifically at elderly cohorts, and quality-of-care programs that reinforce the use of such therapies among these individuals.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

January 2005

Volume

149

Issue

1

Start / End Page

67 / 73

Location

United States

Related Subject Headings

  • Thrombolytic Therapy
  • Registries
  • Outcome Assessment, Health Care
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Hospital Mortality
  • Female
  • Coronary Artery Bypass
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Avezum, A., Makdisse, M., Spencer, F., Gore, J. M., Fox, K. A. A., Montalescot, G., … GRACE Investigators, . (2005). Impact of age on management and outcome of acute coronary syndrome: observations from the Global Registry of Acute Coronary Events (GRACE). Am Heart J, 149(1), 67–73. https://doi.org/10.1016/j.ahj.2004.06.003
Avezum, Alvaro, Marcia Makdisse, Frederick Spencer, Joel M. Gore, Keith A. A. Fox, Gilles Montalescot, Kim A. Eagle, et al. “Impact of age on management and outcome of acute coronary syndrome: observations from the Global Registry of Acute Coronary Events (GRACE).Am Heart J 149, no. 1 (January 2005): 67–73. https://doi.org/10.1016/j.ahj.2004.06.003.
Avezum A, Makdisse M, Spencer F, Gore JM, Fox KAA, Montalescot G, et al. Impact of age on management and outcome of acute coronary syndrome: observations from the Global Registry of Acute Coronary Events (GRACE). Am Heart J. 2005 Jan;149(1):67–73.
Avezum, Alvaro, et al. “Impact of age on management and outcome of acute coronary syndrome: observations from the Global Registry of Acute Coronary Events (GRACE).Am Heart J, vol. 149, no. 1, Jan. 2005, pp. 67–73. Pubmed, doi:10.1016/j.ahj.2004.06.003.
Avezum A, Makdisse M, Spencer F, Gore JM, Fox KAA, Montalescot G, Eagle KA, White K, Mehta RH, Knobel E, Collet J-P, GRACE Investigators. Impact of age on management and outcome of acute coronary syndrome: observations from the Global Registry of Acute Coronary Events (GRACE). Am Heart J. 2005 Jan;149(1):67–73.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

January 2005

Volume

149

Issue

1

Start / End Page

67 / 73

Location

United States

Related Subject Headings

  • Thrombolytic Therapy
  • Registries
  • Outcome Assessment, Health Care
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Hospital Mortality
  • Female
  • Coronary Artery Bypass