Short Term Prognosis of Elderly Patients Admitted to Coronary Care Unit: A Subgroup Analysıs of MORCOR-TURK Trial

OBJECTIVE
Current data on the factors predicting short-term prognosis and mortality in elderly patients hospitalized and followed up in the coronary care unit (CCU) in Turkey are very limited. In the subgroup analysis of the study of predictors of MORtality in CCUs in Turkey (MORCOR-TURK), it was aimed to determine the short-term prognosis, mortality rates and predictors of elderly patients followed in CCUs in Turkey.

METHOD
The MORCOR-TURK trial is a national, non-interventional, multicenter and observational study conducted in Turkey (ClinicalTrials.gov number NCT05296694). The study population include CCUs patients from 50 centers selected from all regions in Turkey (Between 1 and 30 September 2022 prospectively).
In the subgroup analysis of the study, patients were divided into 2 groups: group 1 (65≤ age <75years, n: 923 patients) and group 2 (age ≥75years, n: 713 patients). The end of the analysis, short-term prognosis, mortality rates and predictors were documented. The statistical significance value was accepted as p<0.05.

RESULTS
The mean age of group 1 was 69 (67-72) years and group 2 was 80 (77-84) years (p<0.001). The percentage of female gender was higher in group 2. The most common reason for admission was chest pain (968 patients [59,16%]) and the most common reason for hospitalization in the CCU was acute coronary syndrome (1053 patients [64%]). The second cause of hospitalization in the CCU was heart failure (HF) (259 patients [15.83%]) followed by arrhythmias (171 patients [10.45%]). Atrial fibrillation (AF) was the most common arrhythmia (356 patients [21.76%]). The mortality rate was 6.1% in elderly patients (4.22% in group 1 and 8.55% in group 2). The highest mortality rate was found in patients with ventricular tachycardia/fibrillation (VT/VF) and decompensated HF at follow-up. Among the patients who died, the time of CCU stays was longer. In the multivariate regression analysis; aortic stenosis (p<0.001), AF in hospital (p<0.017), VT/VF in hospital (p<0.001), and acute renal failure (p<0.001) were found to be the main factors that increased mortality, while ejection fraction (p<0.019) and mean blood pressure (p<0.001) elevation were found to be protective on mortality.

CONCLUSION
The subgroup analysis of elderly patients in MORCOR-TURK study is the largest and most comprehensive study in Turkey evaluating the short term prognosis of elderly patients admitted to CCUs.