Abstract 16614: Outcomes Among Nonagenarians Presenting With Acute Coronary Syndrome Undergoing Coronary Angiography: a National Veterans Administration Database Study
Background: Patients often present with acute coronary syndrome (ACS) during their 8th and 9th decades of life. This subpopulation is often underrepresented in clinical trials, receives suboptimal care and management remains challenging and controversial.
Hypothesis: Nonagenarians (age >= 90 years) presenting with ACS undergoing angiography with/without percutaneous coronary intervention (PCI) have higher 30-day mortality and risk of developing contrast nephropathy compared to younger (age < 90 years) patients.
Methods: The study cohort (n=52,432) contains all veterans undergoing coronary angiography or PCI presenting with ACS from 2005-2014. The data are from Department of Veterans Affairs Clinical Assessment, Reporting, and Tracking Program’s dataset (CART). CART captures all coronary angiographies and percutaneous interventions and associated data performed in the 78 angiography labs nationwide.
Results: Clinical characteristics are outlined in Table 1. In unadjusted analyses, nonagenarians had significantly lower BMI, diabetes, family history, hyperlipidemia, and smoking history. Nonagenarians had higher heart failure, cerebrovascular disease, chronic kidney disease and hypertension history. Nonagenarians had higher unadjusted 30-day mortality (Figure 1) and no difference in change in Glomerular Filtration Rate (GFR) pre/post procedure (Table 1).
Conclusion: Compared to younger patients nonagenarians with ACS undergoing angiography with/without PCI had worse 30-day mortality and no significant change in pre/post GFR. Future studies evaluating pre-procedural favorable patient characteristics to reduce mortality risk are warranted.
Author Disclosures: A.C. Sawant: None. V. Singh: None. M.E. Plomondon: None. T. Maddox: None. K.P. Josey: None. A. Sheikh: None. Z. Said: None. B. Rajagopalan: None. M. McIntosh: None. S. Wilk: None. J. Corbelli: None.
- © 2016 by American Heart Association, Inc.