Cardiovascular Disease Association between Comorbidity and Cardiovascular and Cerebrovascular Events in Older Adults with NSTE-ACS

TL;DR

This study shows that older adults with more health issues are at higher risk for serious heart and brain events after a specific type of heart condition.

Contribution

The study demonstrates that comorbidity, measured by aCCI, is a significant predictor of adverse outcomes in older NSTE-ACS patients.

Findings

Higher aCCI scores are linked to a 21.3% increased risk of MACCE per unit increase.

Patients with aCCI ≥5 had an 85.8% higher risk of MACCE compared to those with aCCI <5.

High aCCI patients had more severe biomarkers, frailty, and daily living limitations.

Abstract

To investigate the association between comorbidity and the occurrence of Major Adverse Cardiovascular and Cerebrovascular Events (MACCE) in older adults with Non-ST-Segment Elevation Acute Coronary Syndrome (NSTE-ACS) during one-year discharge. Materials and

A total of 528 adults aged ≥ 65 years old were enrolled from January 2020 to November 2021 at Beijing Friendship Hospital, Capital Medical University for NSTE-ACS. The age-adjusted Charlson Comorbidity Index (aCCI) was calculated based on age and comorbidities. Participants were stratified into the low aCCI group (aCCI < 5) and the high aCCI group (aCCI ≥5). Multivariate COX regression analysis was employed to assess the association between aCCI and the occurrence of MACCE.

The high aCCI group included 251 patients (47.5%). This population exhibited advanced age, higher myocardial injury biomarker levels, and higher prevalence of frailty, polypharmacy, and reduced activities of daily living. When aCCI was analyzed as a continuous variable, the MACCE risk increased by 21.3% (adjusted HR = 1.213, 95%CI:1.043∼1.412, P = 0.012) as aCCI increased by one unit. When aCCI was analyzed as a categorical variable, it is exhibited that the MACCE risk increased by 85.8% (adjusted HR = 1.858, 95% CI: 1.119∼3.083, P = 0.017) in the high group compared to the low group.

Higher comorbidity is associated with increased risk of MACCE during one-year discharge, suggesting that aCCI may serve as a predictor for adverse cerebrocardiovascular outcomes. Early assessment of comorbidity could conduct risk stratification in older adults with NSTE-ACS to implement health management for older adults.