Key result
In elderly patients with coronary artery disease, multivessel disease (HR 4.73), anemia (HR 2.03), left ventricular ejection fraction < 50% (HR 1.98), and left main lesions (HR 1.93) independently predicted 1-year major adverse cardiovascular events.
Why the study?
The study was conducted to investigate clinical characteristics of elderly CAD patients, analyze 1-year prognostic factors, and evaluate the predictive value of the OPT-CAD score for their long-term prognosis.
Cohort (n=4,836)
No
Hazard Ratio: 4.73 (95% CI 1.13–19.82)
p-value: p=0.034
Anemia, left main lesion, multivessel disease, and LVEF <50% are independent predictors of 1-year adverse events in elderly patients with CAD, and the OPT-CAD score offers moderate prognostic value comparable to the GRACE score.
OPT-CAD score shows moderate accuracy for 1-year MACE in elderly CAD; leaves open routine use pending larger prospective validation.
Objective We investigated the clinical characteristics of elderly patients with CAD, analyzed 1-year prognostic factors, and evaluated the predictive value of the Optimal Antiplatelet Therapy for Chinese patients with Coronary Artery Disease (OPT-CAD) score in their long-term prognosis. Methods In this cross-sectional study, 4,836 patients with coronary artery stenosis of 50% or greater aged ≥60 years were included to compare differences in clinical characteristics between the non-elderly group ( n = 3,970, aged 60–74 years) and the elderly group ( n = 866, aged ≥75 years). In the subsequent retrospective cohort study, a subset of 508 patients from the elderly group was followed up for 1 year (with 493 completing follow-up) to analyze risk factors affecting prognosis. The predictive performance of the OPT-CAD score was evaluated by comparing it with the Global Registry for Acute Coronary Events (GRACE) score. Results Elderly patients exhibited lower male prevalence, lipid levels, and BMI but more extensive and severe coronary lesions. Among elderly patients, 10.3% ( n = 51) experienced major adverse cardiovascular event (MACE), with 3.2% mortality ( n = 16). A multivariate analysis identified anemia (HR = 2.03), left main lesion (HR = 1.93), multivessel disease (HR = 4.73), and left ventricular ejection fraction (LVEF) < 50% (HR = 1.98) as independent MACE predictors. The OPT-CAD score demonstrated moderate predictive capacity (AUC=0.628, 95% CI 0.545–0.711, P = 0.003) and was comparable to GRACE in the subgroup analysis (AUC=0.625 vs. 0.632, P = 0.878). Conclusion In elderly patients (≥75 years old), cardiovascular risk factors such as male sex, smoking, lipid profile, and BMI were reduced and could be used to predict ischemic event risk in elderly patients with acute coronary syndrome. Anemia, LM lesion, multivessel coronary artery disease, and low ejection fraction (LVEF < 50%) were independent risk factors for adverse events in elderly patients 1 year after discharge.
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Wang et al. (2026) conducted a cohort in Coronary artery disease (n=4,836). Multivessel coronary artery disease vs. Non-multivessel disease was evaluated on Major adverse cardiovascular events (MACE) at 1 year (HR 4.73, 95% CI 1.13-19.82, p=0.034). In elderly patients with coronary artery disease, multivessel disease (HR 4.73), anemia (HR 2.03), left ventricular ejection fraction < 50% (HR 1.98), and left main lesions (HR 1.93) independently predicted 1-year major adverse cardiovascular events.
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