摘要
Background As treatment of coronary artery disease improved over the last years,management of elder patients remained a matter of debate since this age group has been underrepresented in most trials.The study aimed to evaluate a population of patients with≥85 years old with non-ST-segment elevation myocardial infarction(NSTEMI)and compare the prognosis according to coronary revascularization execution.Methods We retrospectively studied 324 patients included in a national multicenter registry between October 2010 and October 2018,who underwent coronary angiography and had at least one stenosis≥50%.Results In this population,73.1%of the patients underwent percutaneous coronary intervention(PCI)and 26.9%of the patients underwent optimized medical treatment(OMT).The OMT group had more past history of diabetes,stroke and dementia.On coronary angiography,the PCI group used more often the femoral artery access and single-vessel lesions were also more common.Three-vessel disease was more common in the OMT group.During hospitalization,there were more major bleeding events and death in the PCI group.During the one-year follow-up,there were no significant differences in all-cause mortality rate.Conclusions Very old patients with NSTEMI submitted to OMT had more comorbidities and more three-vessel disease,factors that could have influenced the therapeutic decision.Patients undergoing PCI had more in-hospital major bleeding events and mortality,with no significant differences after one year.
