Eficacia de los scores de riesgo hemorrágico en el paciente anciano con síndrome coronario agudo |
| |
Authors: | Albert Ariza-Solé Francesc Formiga Victoria Lorente José C Sánchez-Salado Guillermo Sánchez-Elvira Gerard Roura Remedios Sánchez-Prieto Maria Vila Pedro Moliner Angel Cequier |
| |
Institution: | 1. Unidad Coronaria, Servicio de Cardiología, Hospital Universitario de Bellvitge, L’Hospitalet de Llobregat, Barcelona, España;2. Unidad de Geriatría, Servicio de Medicina Interna, Hospital Universitario de Bellvitge, L’Hospitalet de Llobregat, Barcelona, España;3. Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario de Bellvitge, L’Hospitalet de Llobregat, Barcelona, España |
| |
Abstract: | Introduction and objectivesThe incidence of acute coronary syndromes is high in the elderly population. Bleeding is associated with a poorer prognosis in this clinical setting. The available bleeding risk scores have not been validated specifically in the elderly. Our aim was to assess predictive ability of the most important bleeding risk scores in patients with acute coronary syndrome aged ≥ 75 years.MethodsWe prospectively included consecutive acute coronary syndromes patients. Baseline characteristics, laboratory findings, and hemodynamic data were collected. In-hospital bleeding was defined according to CRUSADE, Mehran, ACTION, and BARC definitions. CRUSADE, Mehran, and ACTION bleeding risk scores were calculated for each patient. The ability of these scores to predict major bleeding was assessed by binary logistic regression, receiver operating characteristic curves, and area under the curves.ResultsWe included 2036 patients, with mean age of 62.1 years; 369 patients (18.1%) were ≥ 75 years. Older patients had higher bleeding risk (CRUSADE, 42 vs 22; Mehran, 25 vs 15; ACTION, 36 vs 28; P<.001) and a slightly higher incidence of major bleeding events (CRUSADE bleeding, 5.1% vs 3.8%; P=.250). The predictive ability of these 3 scores was lower in the elderly (area under the curve, CRUSADE: 0.63 in older patients, 0.81 in young patients; P = .027; Mehran: 0.67 in older patients, 0.73 in younger patients; P = .340; ACTION: 0.58 in older patients, 0.75 in younger patients; P = .041).ConclusionsCurrent bleeding risk scores showed poorer predictive performance in elderly patients with acute coronary syndromes than in younger patients.Full English text available from:www.revespcardiol.org/en |
| |
Keywords: | SCA sí ndrome coronario agudo |
本文献已被 ScienceDirect 等数据库收录! |
|