Key result
Developing ACS during noncardiac illness is linked to higher mortality and performance decline versus primary ACS.
Why the study?
Atypical ACS presentations delay recognition and treatment in older adults, while unique factors like performance status decline influence management and outcomes.
Does developing acute coronary syndrome during hospitalization for noncardiac illness worsen clinical outcomes and performance status in older adults compared to primary admission for ACS?
Observational (n=310)
Does developing acute coronary syndrome during hospitalization for noncardiac illness worsen clinical outcomes and performance status in older adults compared to primary admission for ACS?
Older adults who develop ACS during hospitalization for noncardiac illnesses face higher mortality and functional decline, highlighting the need for vigilance and optimal management in this vulnerable population.
May warrant enhanced ACS surveillance in noncardiac admissions; leaves open whether prevention alters functional decline or mortality.
Background: Atypical presentations of acute coronary syndrome (ACS) delay its recognition and treatment among older adults. Cognitive impairment, frailty, depression, and decline in performance status which is unique to older adults also influence the treatment and outcomes. The present study was conducted to identify the performance status among older adults admitted for noncardiac illnesses, later developing an ACS and their outcome. Materials and Methods: Three hundred and ten older adults with ACS were included from June 26, 2020, to October 13, 2020. Subjects were divided into those admitted primarily due to an ACS (Group I, n = 94) and those developing ACS following admission for noncardiac illness (Group II, n = 216). Comorbidities, medications, investigations, management, and outcomes were compared between the two groups. Results: Majority of them admitted in Group II had a non-ST elevation ACS (90.2%), and acute kidney injury (27.1%) was most commonly associated. Optimum management was given to a lesser extent due to the clinical condition of the patient. A decline in performance status, mortality during hospitalization, and follow-up was higher in Group II. Conclusion: Optimum and aggressive management could not be given to a considerable number of patients in Group II due to their medical condition, adverse effects of drugs, and lack of specialist consultation during an ACS. Clinicians must be vigilant for the decline in performance status when an older adult is admitted to the hospital, as early detection and optimum management provides better clinical and functional outcomes.
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David et al. (2025) conducted an observational in Acute Coronary Syndrome (n=310). Developing ACS during hospitalization for noncardiac illness vs. Admitted primarily due to ACS was evaluated on Decline in performance status and mortality during hospitalization and follow-up. Developing ACS during hospitalization for noncardiac illness (n=216) was associated with a higher decline in performance status and mortality compared to primary ACS admission (n=94).
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