Background Older people less frequently receive invasive coronary angiography (ICA) for NSTEMI than younger patients. We describe care, ICA data, and in-hospital and 30-day outcomes of NSTEMI by age in a contemporary and geographically diverse cohort. Methods Prospective cohort study including 2947 patients with NSTEMI from 287 centres in 59 countries, stratified by age (≥75 years, n = 761). Quality of care was evaluated based on 12 guideline-recommended care interventions, and data collected on ICA. Outcomes included in hospital acute heart failure, cardiogenic shock, repeat myocardial infarction, stroke/transient ischaemic attack, BARC Type ≥3 bleeding and death, as well as 30-day mortality. Results Patients aged ≥75 years, compared with younger patients, at presentation had a higher prevalence of comorbidities and oral anticoagulation prescription (22.4% vs 7.6%, p < 0.001). Older patients less frequently received ICA than younger patients (78.6% vs 90.6%, p < 0.001) with the recorded reason more often being advanced age, comorbidities or frailty. Of those who underwent ICA, older patients more frequently demonstrated 3-vessel, 4-vessel and/or left main stem coronary artery disease compared to younger patients (49.7% vs 34.1%, p < 0.001) but less frequently received revascularisation (63.6% vs 76.9%, p < 0.001). Older patients experienced higher rates of in-hospital acute heart failure (15.0% vs 8.4%, p < 0.001) and bleeding (2.8% vs 1.3%, p = 0.006), as well as in-hospital and 30-day mortality (3.4% vs 1.3%, p < 0.001; 4.8% vs 1.7%, p < 0.001; respectively), than younger patients. Conclusions Patients aged ≥75 years with NSTEMI, compared with younger patients, less frequently received ICA and guideline-recommended care, and had worse short-term outcomes.

中文翻译：

---

不同年龄的 NSTEMI 患者的临床表现、护理、冠状动脉介入治疗和结局：来自国际前瞻性 ACVC-EAPCI EORP NSTEMI 登记的见解


背景 与年轻患者相比，老年人接受 NSTEMI 有创冠状动脉造影 （ICA） 的频率较低。我们描述了当代和地理上不同的队列中按年龄划分的 NSTEMI 的护理、 ICA 数据以及院内和 30 天结局。方法 前瞻性队列研究包括来自 59 个国家/地区 287 个中心的 2947 名 NSTEMI 患者，按年龄分层 （≥75 岁，n = 761）。根据 12 项指南推荐的护理干预措施和 ICA 收集的数据评估护理质量。结局包括医院急性心力衰竭、心源性休克、反复心肌梗死、中风/短暂性脑缺血发作、BARC ≥3 型出血和死亡，以及 30 天死亡率。结果 与年轻患者相比，≥ 75 岁的患者就诊时合并症和口服抗凝药处方的患病率更高 （22.4% vs 7.6%，p < 0.001）。老年患者接受 ICA 的频率低于年轻患者 （78.6% vs 90.6%，p < 0.001），记录的原因更常见的是高龄、合并症或虚弱。在接受 ICA 的患者中，与年轻患者相比，老年患者更频繁地表现出 3 支血管、4 支血管和/或左主干冠状动脉疾病（49.7% 对 34.1%，p < 0.001），但接受血运重建的频率较低（63.6% 对 76.9%，p < 0.001）。老年患者的院内急性心力衰竭发生率（15.0% 对 8.4%，p < 0.001）和出血率（2.8% 对 1.3%，p = 0.006），以及院内和 30 天死亡率（分别为 3.4% 对 1.3%，p < 0.001;4.8% 对 1.7%，p < 0.001;分别为 4.8% 对 1.7%，p < 0.001;）。 结论 与年轻患者相比，≥ 75 岁的 NSTEMI 患者接受 ICA 和指南推荐护理的频率较低，短期结局较差。