Intervention and in-hospital pharmacoterapies in octogenarian with acute coronary syndrome: a 10-year retrospective analysis of the Malaysian National Cardiovascular Database (NCVD) registry

• Published in: BMC geriatrics 2022-01, Vol.22 (1), p.23-10, Article 23
• Main Authors: Suki, Siti Z, Zuhdi, Ahmad S M, Yahya, ' Abqariyah A, Zaharan, Nur L
• Format: Article
• Language: English
• Subjects: Acute coronary syndrome; Acute Coronary Syndrome - diagnosis; Acute Coronary Syndrome - drug therapy; Acute Coronary Syndrome - epidemiology; Acute coronary syndromes; Age groups; Aged; Aged, 80 and over; Angina; Angioplasty; Angiotensin; Angiotensin-converting enzyme inhibitors; Anticoagulants; Aspirin; Beta blockers; Cardiovascular agents; Cardiovascular disease; Cardiovascular diseases; Care and treatment; Clinical trials; Demography; Disease; Dosage and administration; Drug therapy; Ethnicity; Female; Gender; Geriatrics; Health aspects; Heart attacks; Heart failure; Hospitals; Humans; Hypertension; Intervention; Male; Methods; Minority & ethnic groups; Morbidity; Mortality; Myocardial infarction; Octogenarians; Older people; Patients; Peptidyl-dipeptidase A; Percutaneous Coronary Intervention; Pharmacoepidemiology; Pharmacotherapies; Registries; Retrospective Studies; Risk Factors; Statins; Statistical analysis; Statistics; Transluminal angioplasty; Treatment Outcome; Trends
• ISSN: 1471-2318; 1471-2318
• DOI: 10.1186/s12877-021-02724-7

Octogenarians and beyond have often been neglected in the populational study of disease despite being at the highest point of non-modifiable disease risk burden and the fastest-growing age group for the past decade. This study examined the characteristics and in-hospital management of octogenarian patients with acute coronary syndrome (ACS) in a multi-ethnic, middle-income country in South East Asia. This retrospective study utilised the Malaysian National Cardiovascular Disease- ACS (NCVD-ACS) registry. Consecutive patient data of those ≥80 years old admitted with ACS at 24 participating hospitals from 2008 to 2017 (n = 3162) were identified. Demographics, in-hospital intervention, and evidence-based pharmacotherapies over the 10-years were examined and compared across groups of interests using the Chi-square test. Multivariate logistic regression was used to calculate the adjusted odds ratio of receiving individual therapies according to patients' characteristics. Octogenarians made up 3.8% of patients with ACS in the NCVD-ACS registry (mean age = 84, SD ± 3.6) from 2008 until 2017. The largest ethnic group was Chinese (44%). Most octogenarians (95%) have multiple cardiovascular risk factors, with hypertension (82%) being the main. Non-ST-elevation myocardial infarction (NSTEMI) predominated (38%, p