Age as a Prognostic Factor in Patients with Acute Coronary Syndrome undergoing Urgent/Emergency Cardiac Surgery

Elena Crudeli, Chiara Lazzeri, Pierluigi Stefàno, Marco Chiostri, Claudio Blanzola, Alessandra Rossi, Giuseppe Olivo, Stefano Del Pace, Gian Franco Gensini, Serafina Valente

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Patients presenting with acute coronary syndrome (ACS) who require urgent/emergency coronary artery bypass grafting (CABG) are increasing, as is the complexity of their clinical characteristics, one of which is advanced age. We evaluated the prognostic role of age in patients undergoing urgent/emergency cardiac surgery for ACS. Methods: From January to December 2013, 452 consecutive patients underwent CABG at our institution. Among these, 213 presented with ACS, were enrolled in the study and divided into tertiles of age: First: 40-65 years old (n=73), Second: 66-74 (n=70), Third: 75-89 (n=70). Patients were followed post-operatively for 30 days. Results: No differences between tertiles were found for baseline clinical and angiographic characteristics. Off-pump interventions were 67.6%. Older patients more frequently required an associate intervention to CABG for a mechanical complication of ACS. Overall 30-day all-cause mortality was 4.7% (. n=10); 0.6% (n=1) in patients undergoing isolated CABG (n=168, 78.9%). The STEMI diagnosis was an independent risk factor for 30-day mortality, and age was not. Conclusions: The 30-day mortality rate of older ACS patients who undergo urgent/emergency CABG is comparable to that of younger ones. Pre-operative risk assessment should rely on evaluation of the clinical complexity of each patient independent of their chronological age, to customise the therapeutic strategy.

Original languageEnglish
Pages (from-to)845-853
Number of pages9
JournalHeart Lung and Circulation
Volume24
Issue number9
DOIs
Publication statusPublished - Sep 1 2015

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Acute Coronary Syndrome
Thoracic Surgery
Emergencies
Coronary Artery Bypass
Mortality

Keywords

  • Acute coronary syndrome
  • Age
  • Elderly patient
  • Emergency revascularisation
  • Prognostic factor
  • Urgent coronary artery bypass grafting

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine

Cite this

Crudeli, E., Lazzeri, C., Stefàno, P., Chiostri, M., Blanzola, C., Rossi, A., ... Valente, S. (2015). Age as a Prognostic Factor in Patients with Acute Coronary Syndrome undergoing Urgent/Emergency Cardiac Surgery. Heart Lung and Circulation, 24(9), 845-853. https://doi.org/10.1016/j.hlc.2015.02.007

Age as a Prognostic Factor in Patients with Acute Coronary Syndrome undergoing Urgent/Emergency Cardiac Surgery. / Crudeli, Elena; Lazzeri, Chiara; Stefàno, Pierluigi; Chiostri, Marco; Blanzola, Claudio; Rossi, Alessandra; Olivo, Giuseppe; Pace, Stefano Del; Gensini, Gian Franco; Valente, Serafina.

In: Heart Lung and Circulation, Vol. 24, No. 9, 01.09.2015, p. 845-853.

Research output: Contribution to journalArticle

Crudeli, E, Lazzeri, C, Stefàno, P, Chiostri, M, Blanzola, C, Rossi, A, Olivo, G, Pace, SD, Gensini, GF & Valente, S 2015, 'Age as a Prognostic Factor in Patients with Acute Coronary Syndrome undergoing Urgent/Emergency Cardiac Surgery', Heart Lung and Circulation, vol. 24, no. 9, pp. 845-853. https://doi.org/10.1016/j.hlc.2015.02.007
Crudeli, Elena ; Lazzeri, Chiara ; Stefàno, Pierluigi ; Chiostri, Marco ; Blanzola, Claudio ; Rossi, Alessandra ; Olivo, Giuseppe ; Pace, Stefano Del ; Gensini, Gian Franco ; Valente, Serafina. / Age as a Prognostic Factor in Patients with Acute Coronary Syndrome undergoing Urgent/Emergency Cardiac Surgery. In: Heart Lung and Circulation. 2015 ; Vol. 24, No. 9. pp. 845-853.
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AU - Lazzeri, Chiara

AU - Stefàno, Pierluigi

AU - Chiostri, Marco

AU - Blanzola, Claudio

AU - Rossi, Alessandra

AU - Olivo, Giuseppe

AU - Pace, Stefano Del

AU - Gensini, Gian Franco

AU - Valente, Serafina

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N2 - Background: Patients presenting with acute coronary syndrome (ACS) who require urgent/emergency coronary artery bypass grafting (CABG) are increasing, as is the complexity of their clinical characteristics, one of which is advanced age. We evaluated the prognostic role of age in patients undergoing urgent/emergency cardiac surgery for ACS. Methods: From January to December 2013, 452 consecutive patients underwent CABG at our institution. Among these, 213 presented with ACS, were enrolled in the study and divided into tertiles of age: First: 40-65 years old (n=73), Second: 66-74 (n=70), Third: 75-89 (n=70). Patients were followed post-operatively for 30 days. Results: No differences between tertiles were found for baseline clinical and angiographic characteristics. Off-pump interventions were 67.6%. Older patients more frequently required an associate intervention to CABG for a mechanical complication of ACS. Overall 30-day all-cause mortality was 4.7% (. n=10); 0.6% (n=1) in patients undergoing isolated CABG (n=168, 78.9%). The STEMI diagnosis was an independent risk factor for 30-day mortality, and age was not. Conclusions: The 30-day mortality rate of older ACS patients who undergo urgent/emergency CABG is comparable to that of younger ones. Pre-operative risk assessment should rely on evaluation of the clinical complexity of each patient independent of their chronological age, to customise the therapeutic strategy.

AB - Background: Patients presenting with acute coronary syndrome (ACS) who require urgent/emergency coronary artery bypass grafting (CABG) are increasing, as is the complexity of their clinical characteristics, one of which is advanced age. We evaluated the prognostic role of age in patients undergoing urgent/emergency cardiac surgery for ACS. Methods: From January to December 2013, 452 consecutive patients underwent CABG at our institution. Among these, 213 presented with ACS, were enrolled in the study and divided into tertiles of age: First: 40-65 years old (n=73), Second: 66-74 (n=70), Third: 75-89 (n=70). Patients were followed post-operatively for 30 days. Results: No differences between tertiles were found for baseline clinical and angiographic characteristics. Off-pump interventions were 67.6%. Older patients more frequently required an associate intervention to CABG for a mechanical complication of ACS. Overall 30-day all-cause mortality was 4.7% (. n=10); 0.6% (n=1) in patients undergoing isolated CABG (n=168, 78.9%). The STEMI diagnosis was an independent risk factor for 30-day mortality, and age was not. Conclusions: The 30-day mortality rate of older ACS patients who undergo urgent/emergency CABG is comparable to that of younger ones. Pre-operative risk assessment should rely on evaluation of the clinical complexity of each patient independent of their chronological age, to customise the therapeutic strategy.

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