RESUMO
BACKGROUND: Prognosis of acute coronary syndrome (ACS) in elderly patients is bleak. Also older people tend to receive less invasive treatment than younger patients. AIM: To analyze the impact of coronary revascularization on the mid-term outcome of septuagenarian patients admitted with ACS. METHODS: We retrospectively studied 250 patients 70 years or older hospitalised for ACS between january 2006 to september 2010. RESULTS: This population was more likely to be male with mean age 74 years and 93 % of ACS were inaugural events (60% NSTEMI, 40% STEMI). Coronary angiograms showed complex coronary lesions with a high incidence of multivessel disease, bifurcation lesions, and calcified stenosis. Seventy-six patients were treated medically and 174 underwent percutaneous or surgical revascularization. At six-month clinical follow-up, major adverse cardiac events (MACE) were significantly higher in medically treated than revascularized patients (62% Vs 31.7%, P <0.001). Patients with invasive strategy have significantly higher event free survival rate comparing to those assigned to medical management (64% Vs 49.7%, p: 0.01). CONCLUSION: Our study confirmed the superiority of invasive strategy compared to medical treatment in septuagenarian patients with acute coronary syndromes. Advanced age should not exclude patients from invasive strategy with complete revascularization.
