Unfortunate impact of age on the management and outcomes of unstable angina and non-ST elevation myocardial infarction (the GUARANTEE registry)

Olga S. Gurjeva, Matthew T. Roe, Sabina A. Murphy, David J. Moliterno, Christopher P. Cannon

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Few data are available from the registries on the impact of age and gender on treatment and outcomes of patients admitted for unstable angina and non-ST elevation myocardial infarction (UA/NSTEMI). We examined the clinical characteristics, differences in management and outcomes, associated with age in 2948 consecutive patients with UA/NSTEMI. Prospectively collected data from the Global Unstable Angina Registry and Treatment Evaluation (GUARANTEE) registry were analyzed, comparing patients older than 75 years of age and those 75 years and younger. Patients presenting at a younger age, both men and women, were more likely to have a family history of coronary artery disease, to be current smokers, and to have hypercholesterolemia (P < 0.001). Older patients more commonly had a prior history of stroke, angina, myocardial infarction (MI), and congestive heart failure (P < 0.05), and had more diffuse disease on angiography (P < 0.001). Although older women more often "ruled-in" for MI on admission, they were less likely to be cared for by a cardiologist (P < 0.05). A gradient in the use of cardiac catheterization was seen, with greatest use in younger men, 54.2% versus 47.4% for younger women, 43.1% for older men, and the lowest use in older women, 34.5% (P < 0.01). An opposite gradient of in-hospital mortality was seen, with 0.7%, 0.7%, 0.9%, and 3.2% across the 4 groups, respectively, with older women having worse outcomes (P = 0.008). Unfortunately, a "reverse targeting" of procedures to patient risk was seen among elderly, even when stratified by gender, with older patients being higher risk, but less likely to receive appropriate procedures. To improve the outcomes of elderly men and women with UA/NSTEMI, they should be managed more aggressively.

Original languageEnglish
Pages (from-to)81-87
Number of pages7
JournalCritical Pathways in Cardiology
Issue number2
StatePublished - Jun 2005


  • Acute coronary syndromes
  • Age differences
  • Management
  • Medical treatment
  • Outcomes
  • Percutaneous coronary intervention
  • Unstable angina

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


Dive into the research topics of 'Unfortunate impact of age on the management and outcomes of unstable angina and non-ST elevation myocardial infarction (the GUARANTEE registry)'. Together they form a unique fingerprint.

Cite this