Journal of Clinical and Preventive Cardiology (Jan 2020)

In-Hospital and 1 year outcomes of octogenarian Indian patients with heart disease: Results from the elder heart registry

  • Sajan Z Ahmad,
  • Cherian Koshy,
  • George Koshy,
  • Kiran Jacob,
  • K Venugopal

DOI
https://doi.org/10.4103/JCPC.JCPC_22_20
Journal volume & issue
Vol. 9, no. 3
pp. 94 – 101

Abstract

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Aim: The Elder Heart Registry aims to study the demographics, clinical profile, in-hospital, and 1 year outcomes of octogenarian patients (≥80 years) with acute cardiovascular disease. Materials and Methods: This is a prospective observational, longitudinal cohort, single-center registry of octogenarian cardiac patients admitted to the cardiology intensive care unit (CICU) at a tertiary care teaching hospital in Kerala, India for 2 years. Data analysis was performed using SPSS version 20 software. Results: From a total of 4199 patients admitted to the CICU, the Registry enrolled 406 patients aged ≥80 years, which constituted 9.6% of the total admissions (mean age 84.24 ± 3.67 years, male-to-female ratio of 1.15:1, mean follow-up of 1.2 years). Acute coronary syndromes (ACS) constituted 42.1% of admissions, with ST-elevation myocardial infarction in 22.2%, non-ST elevation myocardial infarction in 64.3%, and unstable angina in 13.4%. Presentation with heart failure (HF) was seen in 36.4% of patients, with HF with preserved ejection fraction (HFpEF) in 51.7%. The rates of in-hospital mortality, mortality on follow-up and rehospitalization were 14.0%, 9.3%, and 21% in the ACS group, and 9.4%, 8.1% and 18.9% in the HF group, respectively (12.1%, 8.6%, and 15.5% in the HF with reduced ejection fraction subset and 10%, 8.3%, and 20% in the HFpEF subset). Atrial fibrillation was the most common arrhythmia (16.5%). Apart from systemic hypertension (77.3%) and diabetes mellitus (53.9%), co-morbidities noted were chronic kidney disease (16.7%), obstructive airway disease (8%), thyroid disorders (4%), significant anemia (3%), depression (2.5%), and malignancy (2%). Conclusions: Octogenarians constitute almost 10% of all admissions to the CICU. ACS and HF are the major cardiac causes for hospitalization among these very elderly patients. The Elder Heart Registry is currently the largest series of octogenarian cardiac patients from India.

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