Short-term prognosis of elderly patients admitted to the coronary care unit: a subgroup analysis of the MORCOR-TURK (mortality and morbidity in coronary care units in Turkiye) trial

Abstract

Objective: This subgroup analysis of the MORCOR-TURK (Mortality and Morbidity in Coronary Care Units in Turkiye) trial aimed to determine the short-term prognosis, mortality rates, and predictors for elderly patients followed in coronary care units (CCUs) in Turkiye. Methods: The MORCOR-TURK trial is a national, non-interventional, multicenter observational study conducted in Turkiye (ClinicalTrials.gov number NCT05296694). The study population includes CCU patients from 50 centers selected from all regions of Turkiye (between September 1 and 30, 2022 prospectively). In the subgroup analysis, patients were divided into two groups: Group 1 (ages 65 to < 75 years, n = 923 patients) and Group 2 (ages >= 75 years, n = 713 patients). At the end of the analysis, short-term prognosis, mortality rates, and predictors were documented. Results: The mean age of Group 1 was 69 (67-72) years, and Group 2 was 80 (77-84) years. Chest pain was the most common reason for admission (968 patients [59.16%]), and acute coronary syndrome was the most common reason for hospitalization in the CCU (1,053 patients [64%]). Atrial fibrillation (AF) was the most common arrhythmia (356 patients [21.76%]). The mortality rate was 6.11% in elderly patients (4.23% in Group 1 and 8.56% in Group 2). The multivariate regression analysis showed that age (P = 0.046, P = 0.003), chronic kidney disease (P = 0.011, P = 0.045), and ventricular tachycardia/ventricular fibrillation (VT/VF) during hospitalization (P < 0.001) were the main factors that increased mortality in both groups. Other independent mortality risk factors were smoking for Group 1 and aortic stenosis for Group 2. Conclusion: This study represents the most comprehensive assessment of the short-term prognosis for elderly patients admitted to CCUs in Turkiye. It showed that coronary artery disease was the most common reason for admission and age over 75 and chronic kidney disease were the main determinants of mortality.