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Age-related differences in the use of guideline-recommended medical and interventional therapies for acute coronary syndromes : a cohort study

Schoenenberger, A. W. and Radovanovic, D. and Stauffer, J. C. and Windecker, S. and Urban, P. and Eberli, F. R. and Stuck, A. E. and Gutzwiller, F. and Erne, P. and Acute, Myocardial Infarction in Switzerland Plus Investigators. (2008) Age-related differences in the use of guideline-recommended medical and interventional therapies for acute coronary syndromes : a cohort study. Journal of the american geriatrics society, Vol. 56, H. 3. pp. 510-516.

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Official URL: http://edoc.unibas.ch/dok/A6002984

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Abstract

OBJECTIVES: To compare the use of guideline-recommended medical and interventional therapies in older and younger patients with acute coronary syndromes (ACSs). DESIGN: Prospective cohort study. SETTING: Fifty-five hospitals in Switzerland. PARTICIPANTS: Eleven thousand nine hundred thirty-two patients with ACS enrolled between March 1, 2001, and June 30, 2006. ACS definition included ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina pectoris (UA). MEASUREMENTS: Use of medical and interventional therapies was determined after exclusion of patients with contraindications and after adjustment for comorbidities. Multivariate logistic regression models were used to calculate odds ratios (ORs) per year increase in age. RESULTS: Elderly patients were less likely to receive acetylsalicylic acid (OR=0.976, 95% confidence interval (CI)=0.969-0.980) or beta-blockers (OR=0.985, 95% CI=0.981-0.989). No age-dependent difference was found for heparin use. Elderly patients with STEMI were less likely to receive percutaneous coronary intervention (PCI) or thrombolysis (OR=0.955, 95% CI=0.949-0.961). Elderly patients with NSTEMI or UA less often underwent PCI (OR=0.943, 95% CI=0.937-0.949). CONCLUSION: Elderly patients across the whole spectrum of ACS were less likely to receive guideline-recommended therapies, even after adequate adjustment for comorbidities. Prognosis of elderly patients with ACS may be improved by increasing adherence to guideline-recommended medical and interventional therapies.
Faculties and Departments:03 Faculty of Medicine > Departement Biomedizin > Further Research Groups at DBM > Signal Transduction (Resink/Erne)
UniBasel Contributors:Erne, Paul
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Williams & Wilkins
ISSN:0002-8614
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:20 Jun 2014 07:55
Deposited On:08 Nov 2012 16:16

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