Abstract 14255: Contemporary Characteristics and Management of Patients Aged ≥ 80 Years Presenting With Non-ST Elevation Myocardial Infarctions in the United States: A Nationwide Inpatient Sample Cohort Study

Introduction: Improvements in primary prevention, medical therapies and interventions have coincided with a rapidly aging population across the globe. The contemporary characteristics and in-hospital outcomes of non-ST-elevation myocardial infarction (NSTEMI) among patients ≥ 80 years old in the United States (US) are not well studied. Methods: Adults (≥ 18) with a primary discharge diagnosis of NSTEMI were identified from the 2016 National Inpatient Sample. The exposure of interest was age ≥80 years, with a comparison group of those aged between 18 and 79 years. Results: Of 93,875 patients who had NSTEMI, 22,210 (23.65%) were ≥ 80 years. Among patients ≥ 80 years, 52.5% were female, 73.6% were Caucasians, with a significant proportion being managed by conservative therapy (73.4%). Patients ≥ 80 years were less likely to receive percutaneous coronary intervention (PCI) (adjusted odds ratio [aOR]: 0.49; 95% confidence intervals [CI]: 0.47-0.51) or coronary artery bypass graft surgery (CABG) (aOR: 0.28; 95% CI: 0.25-0.30) when compared to the younger group. Regardless of management strategy, patients ≥ 80 years old had higher inpatient mortality compared to younger patients. Patients ≥ 80 years undergoing PCI experienced more complete heart block, but not other complications, such as cardiogenic shock, cardiac arrest, and stroke, compared to the younger group (Table). NSTEMI patients ≥ 80 years who were managed conservatively or by CABG had a higher Elixhauser comorbidity index than patients undergoing PCI. Conclusions: A significant number of NSTEMI patients in the US were aged ≥ 80 years. Despite overall similar in-hospital complications profiles across management strategies, NSTEMI in patients ≥ 80 years was most often managed conservatively.