TY - JOUR
T1 - Age and outcome after acute coronary syndromes without persistent ST- segment elevation
AU - Hasdai, David
AU - Holmes, David R.
AU - Criger, Douglas A.
AU - Topol, Eric J.
AU - Califf, Robert M.
AU - Harrington, Robert A.
N1 - Funding Information:
From the oDeportment of Cardiology, Robm Medical Center, Petoh Tikvo; bOivision of Cordiovoscular Diseases, Mayo Clime, Rochester; Quke Climcol Research Institute, Durham; and the dOeportment of Cardiology, Cleveland Clime Foundation. Supported by COR Therapeutics, Inc (South Son Franc~sco, Colifj and Schering Plough Research lnstrtute (Kenilworth, NJ). Submitted June IO, 1999; accepted September 19, 2000. Reprint requests: David R. Holmes Jr, MD, Diwston of Internal Medicme and Cor-diovosculor Diseases, Mayo Clinic, 200 First SI SW, Rochester, MN 55905 E-mail: holmer.davidOmayo.edv Copyright 0 2000 by Morby, Inc. 0002.8703/2000/$12.00 + 0 4/1/104758 doi: 10.1067/mhj.2000.104758
PY - 2000
Y1 - 2000
N2 - Background: Although age is the most important variable associated with death among patients with persistent ST-segment elevation, its impact on outcome among patients without persistent ST-segment elevation remains unknown. Moreover, the impact of age on the efficacy of antiplatelet therapy with eptifibatide is unknown. Methods: We analyzed the impact of increased age on outcome (death or [re]infarction) among patients enrolled in PURSUIT (Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy), a prospective, randomized study comparing placebo versus eptifibatide therapy in acute coronary syndromes without persistent ST-segment elevation. The 9461 patients were divided into 10-year age groups: <50, 50-59, 60-69, 70-79, and ≥80. In addition, we examined whether age had an impact on the efficacy of eptifibatide therapy. Results: Eptifibatide improved outcome at 30 days (P = .04). There was no interaction among age and treatment (placebo vs eptifibatide) and adjusted outcome (P = .16 for death or [re]infarction at 30 days). Despite their worse clinical profile, older patients were less likely to undergo coronary angiography at 30 days: 936 (71%), 1489 (68%), 1969 (65%), 1357 (57%), and 193 (38%) in the respective age groups. Death or (re)infarction at 30 days occurred in 121 (9%), 255 (12%), 447 (15%), 460 (19%), and 134 (26%) in the respective age groups, and at 6 months in 149 (11%), 301 (14%), 547 (18%), 575 (24%), and 162 (32%). For a 10-year difference in age group, the adjusted odds for death or (re)infarction were greater by 33% within 30 days and by 34% within 6 months. These trends persisted for patients with or without myocardial infarction on presentation. Conclusions: Age did not significantly affect the efficacy of eptifibatide. Older age among patients with acute coronary syndromes was associated with worse baseline characteristics, fewer invasive procedures, and worse outcome.
AB - Background: Although age is the most important variable associated with death among patients with persistent ST-segment elevation, its impact on outcome among patients without persistent ST-segment elevation remains unknown. Moreover, the impact of age on the efficacy of antiplatelet therapy with eptifibatide is unknown. Methods: We analyzed the impact of increased age on outcome (death or [re]infarction) among patients enrolled in PURSUIT (Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy), a prospective, randomized study comparing placebo versus eptifibatide therapy in acute coronary syndromes without persistent ST-segment elevation. The 9461 patients were divided into 10-year age groups: <50, 50-59, 60-69, 70-79, and ≥80. In addition, we examined whether age had an impact on the efficacy of eptifibatide therapy. Results: Eptifibatide improved outcome at 30 days (P = .04). There was no interaction among age and treatment (placebo vs eptifibatide) and adjusted outcome (P = .16 for death or [re]infarction at 30 days). Despite their worse clinical profile, older patients were less likely to undergo coronary angiography at 30 days: 936 (71%), 1489 (68%), 1969 (65%), 1357 (57%), and 193 (38%) in the respective age groups. Death or (re)infarction at 30 days occurred in 121 (9%), 255 (12%), 447 (15%), 460 (19%), and 134 (26%) in the respective age groups, and at 6 months in 149 (11%), 301 (14%), 547 (18%), 575 (24%), and 162 (32%). For a 10-year difference in age group, the adjusted odds for death or (re)infarction were greater by 33% within 30 days and by 34% within 6 months. These trends persisted for patients with or without myocardial infarction on presentation. Conclusions: Age did not significantly affect the efficacy of eptifibatide. Older age among patients with acute coronary syndromes was associated with worse baseline characteristics, fewer invasive procedures, and worse outcome.
UR - http://www.scopus.com/inward/record.url?scp=0034027115&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0034027115&partnerID=8YFLogxK
U2 - 10.1016/S0002-8703(00)90018-8
DO - 10.1016/S0002-8703(00)90018-8
M3 - Article
C2 - 10783220
AN - SCOPUS:0034027115
SN - 0002-8703
VL - 139
SP - 858
EP - 866
JO - American heart journal
JF - American heart journal
IS - 5
ER -