Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Sep 17;12(9):362.
doi: 10.3390/jcdd12090362.

Clinical Outcomes After Immediate Coronary Angiography in Elderly Versus Younger Patients Suffering from Acute Coronary Syndrome

Anja Radunovic  1 , Ivan Ilic  1   2 , Milica Matic  1 , Miljana Ostojic  1 , Dejan Kojic  1 , Ana Golocevac  1 , Nikola Lazarevic  1 , Aleksandar Mandic  1 , Milosav Tomovic  1 , Petar Otasevic  1   2
Affiliations

Clinical Outcomes After Immediate Coronary Angiography in Elderly Versus Younger Patients Suffering from Acute Coronary Syndrome

Anja Radunovic et al. J Cardiovasc Dev Dis. .

Abstract

(1) Aims: This study aimed to compare cardiovascular outcomes in patients older than 75 years with those of younger patients who underwent interventional treatment for acute coronary syndrome (ACS) at a tertiary university hospital. (2) Methods and Results: This was a retrospective, observational study conducted between January 2016 and December 2021, including 1846 consecutive patients with ACS (older than 75 years n = 203, 11%; younger than 75 years n = 1643, 89%). After admission, patients underwent coronary angiography and subsequently received percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), or medical therapy. The mean age in the older group (O75) was 80 ± 4 years versus 59 ± 9 years in the younger group (Y75) (p < 0.001). Older patients more frequently presented with multivessel coronary disease (O75: 114 [56%] vs. Y75: 727 [44%], p = 0.004), and the left anterior descending artery (LAD) was more often the culprit vessel (O75: 105 [52%] vs. Y75: 684 [41%]). Major adverse cardio-cerebral events (MACCEs) occurred more frequently in patients older than 75 years, mainly due to higher mortality (O75: 14 [6.9%] vs. Y75: 27 [1.6%], p < 0.001) and stroke (O75: 3 [1.5%] vs. Y75: 2 [0.1%], p < 0.001). Multivessel disease was the only factor independently associated with MACCEs (HR 1.417, 95% CI 1.058-1.898, p = 0.02). The incidence of significant bleeding (Bleeding Association Research Consortium (BARC) class ≥ 3) was similar between groups (Y75: 123/1643 [7.5%] vs. O75: 13/203 [6.5%], p = 0.587). (3) Conclusions: Patients older than 75 years have worse short- and long-term prognoses following ACS compared with younger patients. Special attention and a multidisciplinary, personalized approach are required to optimize outcomes in this population.

Keywords: DAPT; P2Y12 inhibitors; PCI; acute coronary syndrome; elderly.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Incidence of adverse cardiovascular events.
Figure 2
Figure 2
Kaplan—Meier survival analysis demonstrating difference in major adverse cardio-cerebral events (MACCE) in patients older than 75 years compared with younger patients.
See this image and copyright information in PMC

References

    1. Damluji A.A., Forman D.E., Wang T.Y., Chikwe J., Kunadian V., Rich M.W., Young B.A., Page R.L., 2nd, DeVon H.A., Alexander K.P., et al. Management of Acute Coronary Syndrome in the Older Adult Population: A Scientific Statement from the American Heart Association. Circulation. 2023;147:e32–e62. doi: 10.1161/CIR.0000000000001112. - DOI - PMC - PubMed
    1. Byrne R.A., Rossello X., Coughlan J.J., Barbato E., Berry C., Chieffo A., Claeys M.J., Dan G.A., Dweck M.R., Galbraith M., et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur. Heart J. 2023;44:3720–3826. doi: 10.1093/eurheartj/ehad870. Erratum in: Eur. Heart J. 2024, 45, 1145. - DOI - PubMed
    1. Virani S.S., Newby L.K., Arnold S.V., Bittner V., Brewer L.C., Demeter S.H., Dixon D.L., Fearon W.F., Hess B., Johnson H.M., et al. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients with Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation. 2023;148:e9–e119. doi: 10.1161/CIR.0000000000001168. Erratum in: Circulation 2023, 148, e148; Erratum in: Circulation 2023, 148, e186. - DOI - PubMed
    1. Dillinger J.G., Laine M., Bouajila S., Paganelli F., Henry P., Bonello L. Antithrombotic strategies in elderly patients with acute coronary syndrome. Arch. Cardiovasc Dis. 2021;114:232–245. doi: 10.1016/j.acvd.2020.12.002. - DOI - PubMed
    1. Urban P., Mehran R., Colleran R., Angiolillo D.J., Byrne R.A., Capodanno D., Cuisset T., Cutlip D., Eerdmans P., Eikelboom J., et al. Defining high bleeding risk in patients undergoing percutaneous coronary intervention: A consensus document from the Academic Research Consortium for High Bleeding Risk. Eur. Heart J. 2019;40:2632–2653. doi: 10.1093/eurheartj/ehz372. - DOI - PMC - PubMed

LinkOut - more resources