Effect of complete revascularization in acute coronary syndr-ome after 75 years old:insights from the BleeMACS registry
Ge WANG1
Xiu-Huan CHEN1
Si-Yi LI1
Ze-Kun ZHANG1
Wei GONG1
Yan YAN1
Shao-Ping NIE1
José P.Henriques2
on behalf of the BleeMACS registry investigators
1.Center for Coronary Artery Disease,Beijing Anzhen Hospital,Capital Medical University,Beijing,China2.Depart-ment of Cardiology,Amsterdam University Medical Center,Amsterdam,the Netherlands
摘要：BACKGROUND The prognostic benefit of complete revascularization in elderly patients(aged over 75 years)with multi-ves-sel disease and acute coronary syndrome(ACS)is currently unclear.This study aimed to determine the long-term prognostic im-pact of complete revascularization in this population.
METHODS We conducted this study using data obtained from the BleeMACS(Bleeding complications in a Multicenter reg-istry of patients discharged after an Acute Coronary Syndrome)registry,which was carried out from 2003 to 2014.The objective was to categorize older patients diagnosed with ACS into two groups:those who underwent complete revascularization and th-ose who did not.Propensity score matching and the Kaplan-Meier analysis were employed to examine differences in one-year cl-inical outcomes.The primary endpoint was major adverse cardiovascular event(MACE),which encompassed a combination of all-cause mortality and myocardial infarction.
RESULTS Out of 1263 patients evaluated,445 patients(35.2％)received complete revascularization.Patients who underwent complete revascularization had a higher prevalence of hypertension and prior percutaneous coronary intervention compared to those who did not.During the one-year follow-up period,complete revascularization was associated with a significantly decre-ased risk of MACE[13.7％vs.20.5％,hazard ratio(HR)=0.63,95％CI:0.45-0.88,P=0.007]and a lower risk of myocardial infarc-tion(5.9％vs.9.9％,HR=0.55,95％CI:0.33-0.92,P=0.02).However,it was not linked to a lower risk of all-cause death(9.5％vs.13.5％,HR=0.68,95％CI:0.45-1.02,P=0.06).Similar results were observed in the subgroup analysis.
CONCLUSIONS Long-term clinical improvements were observed in ACS patients aged over 75 years with multi-vessel dis-ease who achieved complete revascularization.Therefore,adhering to guidelines for complete revascularization should be rec-ommended for elderly patients.
机标关键词：insightsregistryrevaafterfromacutebleemacscomplete
论文发表日期：2023-10-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：9( 728-736 )