Abstract 1044: Temporal Trends in Use of Coronary Artery Bypass Grafting and Outcomes in Octogenarians With Acute Myocardial Infarction
Background: In the context of an aging population, indications for coronary artery bypass grafting (CABG) are expanding.
Objectives: We aimed to describe the temporal changes in the use of CABG and long-term outcomes in octogenarians after acute myocardial infarction (AMI), and to compare them to those observed in younger patients.
Methods: The hospital discharge summary database was used to identify all admissions for AMI in the province of Quebec from March 1996 to March 2007. The physicians’ services and drug claims database was used to record all cardiac procedures.
Results: Among the 128 614 admissions for AMI in Quebec between 1996 and 2007, 10 189 patients underwent CABG within 90 days; a total of 743 CABG patients were aged ≥80 years old. CABG use in octogenarians increased from 0.8% to 3.1% over the study period. The prevalence of comorbidities in octogenarians undergoing CABG tended to increase over time. Short and long-term mortality rates as well as rates of readmissions for cardiac events and repeat revascularization at one year are shown (Table 1⇓). Compared with younger patients, there were trends to improved outcomes over time in octogenarians who underwent CABG, especially for cardiac readmission and repeat revascularization.
Conclusion: CABG use after AMI has increased during the past decade in octogenarians. Despite a worsening profile of comorbidities, outcomes tended to improve in this age group. Mortality remains higher in the elderly, but the rates of cardiac readmissions and repeat revascularization were similar in octogenarians compared to patients aged 65–79 years. CABG use in octogenarians is reasonably safe, with acceptable one-year mortality. Considering the demographic context, these observations are important for the decision making process in the management of AMI and resource allocation.