{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T04:07:20Z","timestamp":1767845240887,"version":"3.49.0"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neth Heart J"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The number of octo and nonagenarians presenting with acute coronary syndrome (ACS) is rising and underreported. Therefore, this study aims to clarify patient characteristics and compare outcomes of an initial invasive strategy versus optimal medical treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All consecutive ACS patients from 2020 until 2023 were admitted, and with EHR data extracted. Multi-variation analyses were carried out in three age groups: 80\u201384, 85\u201389 and 90+.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A\u00a0total of 1,036 consecutive patients over 80\u00a0years old were analyzed. A\u00a0predominance of women, lower rates of angiography\/PCI and hypercholesterolemia were observed in the nonagenarians. CABG was only performed in the 80\u201384\u00a0yrs\u00a0group. No differences in the complication rates (type\u00a03a bleeding, CVA, or secondary ICU admission) between the invasive and OMT group at any age. At 3\u00a0months, a\u00a0trend towards a\u00a0better outcome in all-cause mortality was seen in the invasive group in the age groups: 80\u201384: HR 0.44 (0.19\u20131.04) (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u20090.06), 85\u201389: HR 0.46 (0.20\u20131.07) (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u20090.07) and significant better in 90+: HR 0.16 (0.03\u20130.85) (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u20090.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      In this consecutive cohort of 6,168 ACS patients, 1,036 (17%) were octo- and nonagenarians. Nonagenarians differ compared to 80+ and 85+ patients. At 30\u00a0days, mortality rates were 4% in the 80\u201384 group, 10% in the 85\u201389 group (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u2009&lt;\u202f0.001), and 15% in the nonagenarians (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&lt;\u20090.001). This all-comer single-center study shows that appropriate selection may be feasible for an invasive strategy in ACS octo and nonagenarians in terms of safety and outcome.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12471-025-02003-9","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T14:23:13Z","timestamp":1764598993000},"page":"27-35","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The impact of aging on acute coronary syndromes: an EHR-based analysis"],"prefix":"10.1007","volume":"34","author":[{"given":"Quinten P.","family":"Hoogervorst","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte E. 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