AIM  To analyze the real-world elderly patients with coronary artery disease (CAD) and explore the main risk factors affecting their long-term prognosis.

  METHODS  A retrospective study was performed in 537 elderly CAD patients hospitalized in Xijing Hospital of Air Force Medical University from January 2019 to October 2020. The patients were divided into PCI group (n=439) and drug treatment group (n=98). We followed up the patients and compared the cardiac death events and major adverse cardiovascular events (MACE) between the two groups. The influencing factors affecting the long-term adverse prognosis of coronary artery disease were analyzed.

  RESULTS  The median follow-up time was 34 months and 37 patients were lost to follow-up, among whom 9 cases (9%) were in drug treatment group and 28 cases (6%) in PCI group. In total, there were 34 cases of cardiac death, among whom 4 cases (4%) were in drug treatment group and 30 cases (7%) in PCI group, with no significant difference between the two groups. The risk factors for multivariate COX regression analysis showed that age, triple-vessel coronary artery disease (TVD), atrial fibrillation, left ventricular ejection fraction (LVEF)<50% and ST-elevation myocardial infarction (STEMI) were risk factors for cardiac death. In total, MACE occurred in 110 cases, with 17 cases (19%) in drug treatment group and 93 cases (22%) in PCI group. Multivariate COX regression analysis showed that anemia, TVD and atrial fibrillation were risk factors.

  CONCLUSION  The study suggests that active intervention in TVD and atrial fibrillation, reduced LVEF and improvement of anemia may be important therapeutic measures to reduce cardiac death and MACE in elderly patients with coronary artery disease.