Older Patients Benefit from Aggressive Heart Care

Patients over age 80 with acute coronary syndromes are not always getting the aggressive treatments that could help them, a Norwegian study found.

In research presented March 16 at the American College of Cardiology meeting in San Diego, CA, Nicolai Tegn, MD, a cardiologist at Rikhospitalet Oslo University Hospital said his study randomized a group of 458 patients over 80 with non ST-elevation myocardial infarction (NSTEMI) or unstable angina. The study involved 16 health centers in Norway.

About half the patients got non-invasive care and half had angiography. Of the angiography group, 48% then had either balloon angioplasty, stenting, or both. Three percent of the group had coronary bypass surgery.

At a median follow up time of 18 months, the group that had more aggressive care showed a 47% reduction in serious cardiac events, including death.

Compared to peers in the US, the Norwegian population studied could be different in ways not examined in the study, but the findings are relevant since as many as 4 out of 5 Americans over age 80 have at least one condition related to the buildup of plaque in coronary arteries.

Treatment in the US varies widely by physician preference and access to care. NSTEMI and unstable angina are often managed with medications, lifestyle changes and diet modification in these older patients.

They are generally less likely than younger patients to have angiography, stenting, or bypass surgery. Tegn said, it is worth treating these older patients aggressively.

Statistically, US men over 80 can expect to live an average of 8.2 years more and women even longer (9.7 years). “The fact that many 80-year-olds have nearly a decade of life ahead of them makes these results particularly noteworthy," Tegn said.