# 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.

## Key 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.

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Source: https://tomesphere.com/paper/PMC12760805