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Heart Guidelines Still Beneficial for 90-Year-Olds

Study shows adherence to treatment guidelines reduces mortality in older elderly

WEDNESDAY, April 25 (HealthDay News) -- Elderly patients, aged 90 years and older, with non-ST-segment elevation acute coronary syndromes can still benefit from following guideline-recommended therapies, according to a report in the May 1 issue of the Journal of the American College of Cardiology.

Since the elderly are often excluded or underrepresented in trials of non-ST-segment elevation acute coronary syndromes (NSTE-ACS), Adam H. Skolnick, M.D., from Beth Israel Deaconess Medical Center in Boston, and colleagues used data from 5,557 patients aged 90 years or older in the CRUSADE registry to measure baseline characteristics, treatment patterns and clinical outcomes.

The older elderly were less likely to receive glycoprotein IIb/IIIa inhibitors, statins or cardiac catheterization within the recommended times and were more likely to die or have adverse events than similar patients aged 75 to 89 years. Increasing adherence to guidelines was associated with increased bleeding but reduced in-hospital mortality, ranging from 18.9 percent for low adherence to 11.1 percent for high adherence. Older patients were less likely to be diabetic, smokers or obese.

"These findings reinforce the importance of optimizing care patterns for even the oldest patients with NSTE-ACS, while examining novel approaches to reduce the risk of bleeding in this rapidly expanding patient population," the authors conclude.

CRUSADE was funded by the Schering-Plough Corporation, Bristol-Myers Squibb/Sanofi Pharmaceuticals and Millennium Pharmaceuticals.

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