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A Risk-Adjusted Retrospective Data Analysis between Younger and Elderly Patients with Acute Coronary Syndromes—Long-Term Prognosis

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Open Journal of Emergency Medicine 2016年第3期4卷 53-61页

作者： Alexandre de Matos Soeiro Alyne Pinto Borba Aline Siqueira Bossa cindel nogueira zullino Maria Carolina Feres de Almeida Soeiro Tatiana de Carvalho Andreucci Torres Leal Carlos V. Serrano Múcio Oliveira Tavares Emergency Care Unit Heart Institute (InCor) University of S&atilde o Paulo Medical School S&atilde o Paulo Brazil

Purpose: To compare the demographic data and outcomes of younger versus elderly patients with acute coronary syndromes. Methods: This was a retrospective data bank analysis study with 966 patients (268 in the younger group (less than 55 years) and 698 in the elderly group (more than 55 years)). Data were obtained about clinical characteristics, angiography, and medication used at hospital and coronary definitive treatment. The primary endpoint was all cause of in-hospital death and combined events. Comparison between groups was made by Anova and Q-square. Multivariative analysis was determined by logistic regression and was considered significative when p < 0.05. Long-term mortality and combined events were studied using Kaplan- Meyer curves with median follow-up of 11.21 months. Results: The median age in the younger group was 48 years versus 69 years in the elderly group. In the younger group 26% was ST-myocardial infarction versus 18% in the elderly group. About 7% of younger patients were submitted to coronary bypass surgery and 42% to percutaneous coronary angioplasty versus 12% and 25% in elderly group, respectively. Significant difference was observed between the younger versus elderly groups in deaths (1.5% × 7.5%, p = 0.004), combined events (14.9% × 26.3%, p = 0.02) and killip III/IV (3.7% × 8.3%, p = 0.04). Long-term mortality was 3.7% × 10.2%, p = 0.01). Conclusions: In patients with acute coronary syndromes age was an important predictor factor of mortality and complications. Significative differences in outcomes were observed between the two groups in-hospital and long-term follow-up.

关键词： Young Elder Acute Coronary Syndrome

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Prognosis of Patients with Acute Coronary Syndromes and Bleeding—The Importance of Routine Use of a Bleeding Risk Score

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World Journal of Cardiovascular Diseases 2015年第12期5卷 327-334页

作者： Alexandre de Matos Soeiro Ricardo Cesar Campos Devezae Silva Aline Siqueira Bossa cindel nogueira zullino Tatiana de Carvalho Andreucci Torres Leal Maria Carolina Feres de Almeida Soeiro Carlos V. Serrano Jr. Múcio Tavares Oliveira Jr. Emergency Unit-Heart Institute University of Sao Paulo Medical School Sao Paulo Brazil

Introduction: Recent studies showed relation between mortality and bleeding in acute coronary syndromes. Objective: The objective is to analyze the prognosis of patients with acute coronary syndromes with or without in-hospital major and/or minor bleedings. Methods: This was a pro-spective data bank analysis study with 546 patients (39 with bleeding (group I) and 507 without bleeding (group II)) with acute coronary syndromes included between May 2010 and May 2013. Besides, Mehran bleeding risk score was calculated to all patients. The primary endpoint was all causes of in-hospital death and combined events. Comparison between groups was made by Anova and Q-square. Multivariate analysis was determined by logistic regression and was considered significant when p p = 0.005) and combined events (35.9% vs 11.4%, p < 0.001). The same results were observed in multivariate and long-term analysis. Con-clusions: Almost half of patients with acute coronary syndromes had higher risk of bleeding, and that with major or minor bleedings had greater deaths and combined events.

关键词： Unstable Angina Bleeding Acute Myocardial Infarction

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