Chonnam Med J.  2018 Jan;54(1):41-47. 10.4068/cmj.2018.54.1.41.

Clinical Outcomes of Elderly Patients with Non ST-Segment Elevation Myocardial Infarction Undergoing Coronary Artery Bypass Surgery

• Kim WJ
• Jeong MH
• Kang DG
• Lee SU
• Cho SK
• Ahn Y
• Kim YJ
• Kim CJ
• Cho MC
• and Other Korea Acute Myocardial Infarction Registry (KAMIR) Investigators

• KMID: 2458584
• DOI: http://doi.org/10.4068/cmj.2018.54.1.41

Abstract

The aim of this study is to investigate the clinical outcomes of the elderly patients with Non ST-segment elevation myocardial infarction (NSTEMI) undergoing coronary artery bypass surgery (CABG) compared to non-elderly patients. Patients with NSTEMI and undergoing CABG (n=451) who were registered in the Korea Acute Myocardial Infarction Registry between December 2003 and August 2012 were divided into two groups.; the non-elderly group ( < 75 years, n=327) and the elderly group (≥75 years, n=124). In-hospital mortality was higher in the elderly group (4.9% vs. 11.3%, p=0.015), but cardiac death, myocardial infarction, and major adverse cardiovascular events (MACE) including cardiac death, myocardial infarction, percutaneous revascularization, and redo-CABG after a one-year follow up were not different between the two groups. Predictors of in-hospital mortality in patients with NSTEMI undergoing CABG were left ventricular (LV) dysfunction (ejection fraction ≤40%) [hazard ratio (HR): 2.76, 95% confidence interval (CI): 1.16-6.57, p=0.022] and age (HR: 1.05, 95% CI: 1.01-1.10, p=0.047). So elderly NSTEMI patients should be considered for CABG if appropriate, but careful consideration for surgery is required, especially if the patients have severe LV systolic dysfunction.

Keyword

Myocardial Infaction; Coronary Artery Bypass; Aged

MeSH Terms

Aged*
Coronary Artery Bypass*
Coronary Vessels*
Death
Follow-Up Studies
Hospital Mortality
Humans
Korea
Myocardial Infarction*

Figure

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  FIG. 1 Graph of age distribution in Non ST-segment elevation myocardial infarction (NSTEMI) patients undergoing coronary artery bypass surgery (CABG).

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  FIG. 2 Trend of in-hospital mortality rate.

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  FIG. 3 Kaplan-Meier estimates of the incidences of (A) cardiac death, (B) myocardial infarction, (C) major adverse cardiac event (MACE) between non-elderly and elderly groups at one-year follow up.

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