Aging Hearts: Prognostic Insights into Elderly Patients with Non-ST Elevation Myocardial Infarction in the Intensive Cardiac Unit

Introduction:
As the population ages, managing cardiovascular conditions in elderly patients, particularly those aged 85+, has become a clinical priority. Non-ST elevation myocardial infarction (NSTEMI) in this cohort presents unique challenges. However, this age group remains underrepresented in clinical trials, with limited data on outcomes and prognosis in intensive cardiac care units.

Aim: The aim of the current study was to examine the clinical outcomes and yield of coronary intervention among elderly patients who admitted to intensive cardiovascular care unit (ICCU) with NSTEMI compared to younger patients group.

Methods: We included all admitted patients to ICCU between July 2019 and June 2024 with NSTEMI and divided them into 2 groups according to their age (younger than 85 years old or 85 years old and older). Patients were followed up for 45 days, 6 months and more than 6 months.

Results: The study included 967 patients, 137 (14%) of them ≥85 years old, with a mean age of 73.7 (±8.9 y.o). Invasive treatment strategy was slightly higher in the younger group, with [68.64% vs. 64.44%, p <0.05] for the percutaneous coronary intervention (PCI) and [24.85% vs. 19.26%, p <0.05] for the angiography without intervention. Mortality rate was higher in patients older than 85 years old during the follow up periods: 45 days [14.6% vs. 5.9%, p <0.001]; 6 months [19.7% vs. 8.5%, p <0.001] and after 6 months [42.34% vs. 17.85%, p <0.001].

Conclusion: As the population ages, an increasing number of patients with NSTEMI are being admitted to the cardiac intensive care unit. Follow-up of a cohort of patients over the age of 85 reveals higher mortality rates despite invasive treatment, raising the question of whether this patients group should undergo initial catheterization.