In elderly chronic coronary syndrome patients, 48% had major cardiovascular hospitalizations over their lifespan, with heart failure being most frequent; hypertension, diabetes, prior HF, and atrial f
Nearly half of elderly patients with chronic coronary syndromes experience a major cardiovascular hospitalization during their remaining lifespan, most commonly for heart failure, with risk driven by hypertension, diabetes, prior heart failure, and atrial fibrillation.
Absolute Event Rate: 0% vs 0%
Abstract Background There is limited information about the burden of major cardiovascular morbidity in elderly patients with chronic coronary syndromes for the whole life span. Objective Our aim was to investigate the cumulative rate of major cardiovascular events for the whole life span in patients of 75 years or older with chronic coronary syndromes, and to identify clinical predictors of these events. Methods We included all consecutive outpatients with chronic coronary syndromes attended from January 2000 to December 2008 in two cardiology consultations of a tertiary referral hospital in the South of Spain in a prospective study, and followed them until death. All major cardiovascular events (hospitalizations for heart failure –HF-, acute myocardial infarction –AMI- and stroke/transient ischemic attack -TIA) were registered, and cumulative incidence of each event and the composite of any of them were calculated. Predictors of these events were searched by means of multivariate Cox proportional hazards method. Results Out of 421 patients included, 414 had died at December 31st, 2025 (5 were lost in follow up and 2 were still alive) and constitute the study sample. Mean age was 79±4 years, 36% being female. Inclusion criteria were previous acute coronary syndrome in 377 (91%), previous revascularization in 107 (26%), and angina with objective evidence of ischemia in 22 (5%). After up to 22 years’ follow-up (median 7 years, percentile 25-75 4-11 years) 198 patients (48%) had at least one major cardiovascular event (122 patients had 209 hospitalizations for HF, 49 patients suffered 58 AMI and 74 patients were admitted for 81 episodes of stroke/TIA). Cumulative incidence at 5 and 10 years were 33% and 53% for any event, 17% and 34% for HF, 9% and 14% for AMI and 14% and 22% for stroke/TIA. Several risk factors, cardiac conditions and biochemical, haematological and treatment variables were associated with first event incidence (table). In multivariate analysis, independent predictors of suffering a major cardiovascular hospitalization were hypertension (Hazard Ratio 1.58 95% Confidence Interval 1.15-2.18 p=0.005), diabetes (HR 1.38 1.03-1.85 p=0.031), previous heart failure (HR 2.52 1.59-4.01, p=0.000) and atrial fibrillation (1.68 1.13-2.50 p=0.011). Conclusion Nearly half of elderly patients with chronic coronary syndromes had a hospitalization for a major cardiovascular event in their whole life span in this prospective, monocentric study. Heart failure was the most frequent event. Several clinical variables could be useful for stratifying the risk of events.Table Figure
Mesa et al. (Sat,) reported a other. In elderly chronic coronary syndrome patients, 48% had major cardiovascular hospitalizations over their lifespan, with heart failure being most frequent; hypertension, diabetes, prior HF, and atrial f.