Age-related differences in the use of guideline-recommended medical and interventional therapies for acute coronary syndromes: a cohort study.

Details

Serval ID
serval:BIB_6FE9102FC2C2
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Age-related differences in the use of guideline-recommended medical and interventional therapies for acute coronary syndromes: a cohort study.
Journal
Journal of the American Geriatrics Society
Author(s)
Schoenenberger A.W., Radovanovic D., Stauffer J.C., Windecker S., Urban P., Eberli F.R., Stuck A.E., Gutzwiller F., Erne P.
ISSN
1532-5415[electronic]
Publication state
Published
Issued date
2008
Volume
56
Number
3
Pages
510-516
Language
english
Abstract
OBJECTIVES: To compare the use of guideline-recommended medical and interventional therapies in older and younger patients with acute coronary syndromes (ACSs). DESIGN: Prospective cohort study. SETTING: Fifty-five hospitals in Switzerland. PARTICIPANTS: Eleven thousand nine hundred thirty-two patients with ACS enrolled between March 1, 2001, and June 30, 2006. ACS definition included ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina pectoris (UA). MEASUREMENTS: Use of medical and interventional therapies was determined after exclusion of patients with contraindications and after adjustment for comorbidities. Multivariate logistic regression models were used to calculate odds ratios (ORs) per year increase in age. RESULTS: Elderly patients were less likely to receive acetylsalicylic acid (OR=0.976, 95% confidence interval (CI)=0.969-0.980) or beta-blockers (OR=0.985, 95% CI=0.981-0.989). No age-dependent difference was found for heparin use. Elderly patients with STEMI were less likely to receive percutaneous coronary intervention (PCI) or thrombolysis (OR=0.955, 95% CI=0.949-0.961). Elderly patients with NSTEMI or UA less often underwent PCI (OR=0.943, 95% CI=0.937-0.949). CONCLUSION: Elderly patients across the whole spectrum of ACS were less likely to receive guideline-recommended therapies, even after adequate adjustment for comorbidities. Prognosis of elderly patients with ACS may be improved by increasing adherence to guideline-recommended medical and interventional therapies.
Keywords
Acute Coronary Syndrome/therapy, Adrenergic beta-Antagonists/therapeutic use, Age Factors, Aged, Aged, 80 and over, Cohort Studies, Female, Guideline Adherence, Hematologic Agents/therapeutic use, Humans, Male, Middle Aged, Myocardial Revascularization, Practice Guidelines as Topic, Switzerland, Thrombolytic Therapy
Pubmed
Web of science
Create date
02/10/2009 17:19
Last modification date
20/08/2019 14:28
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