"Our study is unique in that it describes early use of therapies, defined as those within the first 24 hours, and is targeted at guideline-recommended care. In fact, although improvements have been realized in adherence to discharge therapies, we found early use of therapies was where some of the largest differences between young and old patients remained. In addition, we demonstrated an inverse relationship between the number of evidence-based therapies applied and in-hospital death in young and old subgroups alike. Although any observational analysis may suffer from residual confounding, we demonstrate that older patients, as a group, benefit equally from guideline-recommended care," said Karen P. Alexander, M.D., from the Duke University Medical Center in Durham, North Carolina.
This analysis used data collected as part of an effort to document the real-world treatment of patients with acute coronary syndromes, including unstable angina and heart attacks. Information on 56,963 patients treated at 443 hospitals across the U.S. was collected for the CRUSADE National Quality Improvement Initiative from January 2001 to June 2003. CRUSADE is an initiative that is designed to increase the practice of evidence-based medicine for patients diagnosed with non-ST segment elevation acute coronary syndromes (NSTE ACS).
The patients were split into four age groups (younger than 65, 65 to 74, 75 to 84, and 85 or older). Rates of rapid use of drugs that reduce or prevent blood clots decreased with age. Elderly patients were also less likely to undergo diagnostic catheterizatio
Contact: Amy Murphy
American College of Cardiology