Acute coronary syndromes in the very elderly: Short term prognostic performance of the SYNTAX score

We performed a retrospective, single-centre prognostic study including patients aged 85 years or more who underwent coronary angiography for ACS over a 4 year period. The primary endpoint was length of stay, and the secondary endpoint was in-hospital mortality. In total, 70 patients were included (37 men), average age 87.0 ± 2.5 years. Average SYNTAX score was 19.0 ± 14.9. Average length of stay was 13.1 ± 7.8 days. By multivariate analysis, SYNTAX score was correlated with length of stay (p = 0.008). Seven (10%) patients died in-hospital. Patients who died had a higher SYNTAX score (p = 0.013) (threshold value of 25) and a lower left ventricular ejection fraction (p = 0.001). They more frequently had signs of heart failure at admission (p = 0.002), ST segment elevation ACS (p = 0.046) and left main stem involvement (p = 0.041) than survivors. In our study, SYNTAX score was associated with length of stay and in-hospital mortality. A SYNTAX score of 25 or more seems to be an indicator of poor short-term prognosis in very elderly patients with ACS.