# Hospitalizations for Major Cardiovascular Events in Patients Aged 75 Years or Older with Chronic Coronary Syndrome for the Whole Life Span

## TL;DR

This study found that nearly half of elderly patients with chronic coronary syndrome are hospitalized for major cardiovascular events in their lifetime, with heart failure being the most common cause.

## Contribution

The study provides the first detailed analysis of lifetime hospitalization rates for major cardiovascular events in elderly patients with chronic coronary syndrome.

## Key findings

- 48% of elderly patients with chronic coronary syndrome experienced at least one major cardiovascular event requiring hospitalization.
- Heart failure was the most common cause of hospitalization for major cardiovascular events.
- Hypertension, diabetes, prior heart failure, and atrial fibrillation were independent predictors of hospitalization for major cardiovascular events.

## Abstract

Background/Objectives: Limited information exists on the burden of major cardiovascular morbidity in elderly patients with chronic coronary syndrome (CCS). Our objective was to investigate the cumulative incidence of lifetime hospitalizations for major cardiovascular events (MCE) in patients aged 75 years or older with CCS and to identify clinical predictors of these events. Methods: All consecutive outpatients aged 75 years or older with CCS seen in two consultations at a tertiary hospital between 2000 and 2008 were included in a prospective study and followed until death. All MCEs requiring admission (hospitalizations for heart failure (HF), acute myocardial infarction, and stroke) were recorded, and the cumulative incidence of each event and the combination of all events was calculated, considering death without admission as a competing event. Results: A total of 414 patients were selected (mean age was 79 ± 4 years, 36% women). After a 22-year follow-up (median 7 years, p25–75 4–11), 198 patients (48%) experienced at least one MCE, the most common being hospitalization for HF (122 patients had 209 hospitalizations). The 10 and 20-year cumulative incidence was 41% (95% CI 36–46%) and 48% (43–53%) for any event. In multivariate analysis, independent predictors of hospitalization for MCE were hypertension (HR 1.58 [95% CI:1.15–2.18], p = 0.005), diabetes (HR 1.38 [1.03–1.85], p = 0.031), prior HF (HR 2.52 [1.59–4.01], p < 0.0005), and atrial fibrillation (HR:1.68 [1.13–2.50], p = 0.011). Conclusions: Nearly half of elderly patients with CCS were hospitalized for MCE during their lifetime. HF was the most common event. Several clinical variables could be useful to stratify the risk of events.