Background and Objective There is little long-term outcome data regarding acute coronary syndrome (ACS) in Chinese older populations (>80 years old). Long-term outcomes of older patients with ACS maybe associated with increased coronary artery lesion severity.
Methods and Results We classified 536 consecutive older patients with ACS based on the Gensini score into 4 groups: a control group (group 1), a group with Gensini score < 20 (group 2), a group with Gensini score from 21 to 60 (group 3), and a group with Gensini score > 61 (group 4). Survival and MACE rates were calculated using the Kaplan-Meier method. Multivariate Cox regression was used to identify mortality predictors. There were 66 (12.3%), 141 (26.3%), 167 (31.2%) and 162 (30.2%) patients in groups 1, 2, 3 and 4, respectively. The average follow-up was 27.1 ± 16.0 months. Heart rate, systolic blood pressure (SBP), eject fraction (EF), blood glucose level, e-GFR, morbidity from old myocardial infarction, smoking, ACS type, and GRACE score were the determinants of coronary artery lesion severity. Increasing coronary artery lesion severity was associated with increased long-term mortality and MACE rates. The overall long-term mortality rate was 9.1% and increased from 3.0% in group 1 to 16.7% in group 4. Age, gender, heart rate, SBP, chronic renal failure, e-GFR, GRACE score, Gensini score, and ACS type were the independent predictors of long-term mortality.
Conclusions Long-term mortality of older patients with ACS was associated with increased coronary artery lesion severity. Gender and chronic renal failure were the major risk factors for long-term mortality.