Bleeding risk scores in elderly Algerian patients with acute coronary syndromes

Abstract

Introduction

The incidence of acute coronary syndromes is high in the elderly population. Bleeding is associated with a poorer prognosis in this clinical setting.

Objective

Our aim was to assess predictive ability of the most important bleeding risk scores in Algerian patients with acute coronary syndrome aged > 75 years.

Method

We prospectively included consecutive acute coronary syndromes patients. Baseline characteristics, laboratory findings, and hemodynamic data were collected. In-hospital bleeding was defined according to CRUSADE, Mehran, ACTION, and BARC definitions. CRUSADE, Mehran, and ACTION bleeding risk scores were calculated for each patient. The ability of these scores to predict major bleeding was assessed by binary logistic regression, receiver operating characteristic curves, and area under the curves.

Results

We included 645 patients, with mean age of 61.2 years; 122 patients (19%) were > 75 years. Older patients had higher bleeding risk (CRUSADE, 42 vs. 22; Mehran, 25 vs. 15; ACTION, 36 vs. 28; P < 0.001) and a slightly higher incidence of major bleeding events (CRUSADE bleeding, 5.1% vs. 3.8%; P = 0.250). The predictive ability of these 3 scores was lower in the elderly (area under the curve, CRUSADE: 0.63 in older patients, 0.81 in young patients; P = 0.027; Mehran: 0.67 in older patients, 0.73 in younger patients; P = 0.340; ACTION: 0.58 in older patients, 0.75 in younger patients; P = 0.041).

Conclusion

Current bleeding risk scores showed poorer predictive performance in elderly patients with acute coronary syndromes than in younger patients.