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タイトル: In-hospital Outcome in Octogenarians with Acute Coronary Syndrome Undergoing Emergent Coronary Angiography
著者: Oe, Kotaro
Shimizu, Masami
Ino, Hidekazu
Yamaguchi, Masato
Terai, Hidenobu
Hayashi, Kenshi link image link image
Kiyama, Masaru
Sakata, Kenji
Hayashi, Tatsumi
Inoue, Masaru
Kaneda, Tomoya
Mabuchi, Hiroshi
井野, 秀一
清水, 賢巳
林, 研至
坂田, 憲治
馬渕 , 宏
発行日: 2003年 4月10日
出版社(者): Japanese Heart Journal
雑誌名: Japanese Heart Journal
ISSN: 0021-4868
巻: 44
号: 1
開始ページ: 11
終了ページ: 20
キーワード: Acute coronary syndrome
Octogenarian
Coronary angiography
抄録: Very elderly patients have higher mortality rates than younger patients after acute coronary syndrome (ACS). However, the mechanism by which increasing age contributes to such mortality remains unclear. In addition, the efficacy and safety of invasive coronary procedures for octogenarians with ACS have not been well established. We compared the clinical characteristics and in-hospital outcome of 193 octogenarians (mean age, 83 years) with those of 1,462 younger patients (mean age, 64 years) with ACS who underwent emergent coronary angiography. Octogenarians included a greater number of females, had higher rates of cerebrovascular disease and multivessel disease, a higher Killip class, a higher Forrester class, and lower rates of smoking, diabetes, and hypercholesterolemia than the younger subjects. Interventions, including percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG), were performed less frequently in octogenarians than in younger patients (88.0% versus 90.8%). The procedural success rate in octogenarians did not differ from that in younger patients. However, the in-hospital mortality rate for the octogenarians was about three times higher than for the younger patients (19.2% versus 6.9%). Multivariate analysis revealed that the predictors of in-hospital mortality in the octogenarians were a higher Killip class and a higher Forrester class. Octogenarians with ACS had fewer coronary risk factors and a similar success rate for the intervention, but had more greatly impaired hemodynamics and higher in-hospital mortality than the younger patients. Therefore, impaired myocardial reserve may contribute to a large portion of in-hospital deaths in octogenarians with ACS.
DOI: 10.1536/jhj.44.11
URI: http://hdl.handle.net/2297/28383
関連URI: http://www.jstage.jst.go.jp/article/jhj/44/1/44_11/_article
資料種別: Journal Article
権利関係: Copyright (c) 2003 by the Japanese Heart Journal
版表示: publisher
出現コレクション:1. 査読済論文

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