Life expectancy with coronary artery disease
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Life Expectancy in Coronary Artery Disease: Key Factors
Impact of Coronary Artery Disease on Life Expectancy
Coronary artery disease (CAD) is a leading cause of death worldwide and significantly reduces life expectancy, especially in older adults. The risk of death from myocardial infarction (heart attack) increases with age, and most deaths from heart attacks occur in people over 70 years old 65. In young adults diagnosed with CAD, long-term survival is also poor, with a 15-year mortality rate of 30%. This risk is much higher for those with diabetes (65% mortality at 15 years), prior heart attacks (45%), or severely reduced heart function (83%) .
Effects of Treatment and Medication on Survival
For elderly patients with CAD, adherence to modern treatment regimens is high and has a significant impact on life expectancy. Certain medications are associated with notable increases in survival: ACE inhibitors can add up to 7 years, aspirin (acetylsalicylic acid) up to 4 years, and statins or beta-blockers up to 2 years. The most effective combinations of these drugs can result in average survival ages of around 80 years for elderly patients .
Revascularization and Long-Term Outcomes
In elderly patients with complex CAD (such as three-vessel or left main disease), both percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) offer similar 10-year survival rates and life expectancy. There is no significant difference in long-term mortality or quality of life between these two procedures in patients over 70 years old . However, a meta-analysis shows that elderly patients who undergo CABG may actually have better long-term survival than the general population of the same age, with this benefit becoming clear after the first year following surgery .
Influence of Comorbid Conditions
The presence of other health conditions, such as high blood pressure and diabetes, further reduces the chances of surviving to age 80 in elderly CAD patients. Predictive models show that these comorbidities have a strong negative impact on life expectancy, while conditions like chronic obstructive pulmonary disease and high cholesterol have a less significant effect .
Global Trends and Prevention
Globally, CAD remains the top cause of death and disability, but mortality rates have been declining in developed countries due to better acute treatment and preventive measures. In contrast, developing countries are seeing variable and sometimes rising rates of CAD, influenced by lifestyle changes and limited access to healthcare .
Conclusion
Life expectancy for patients with coronary artery disease is influenced by age, comorbid conditions, and the effectiveness of treatment. Elderly patients can achieve survival rates close to or even better than their peers without CAD when treated with optimal medication combinations and, in some cases, surgical interventions like CABG. However, the presence of diabetes, high blood pressure, and poor heart function significantly worsens prognosis. Continued improvements in treatment and prevention are essential to further increase life expectancy for people with CAD.
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