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Heart. 2019 Nov;105(21):1635-1641. doi: 10.1136/heartjnl-2019-314978. Epub 2019 May 29.

Bedside mental status and outcome in elderly patients admitted for acute coronary syndromes.

Author information

EA4650, Normandie Université, Caen, France.
Department of Cardiology, Centre Hospitalier Universitaire de Caen, Caen, Basse-Normandie, France.
ACTION academic research group, Pitié-Salpêtrière University Hospital, Paris, France.



We investigated whether mental status assessed by simple bedside tests in elderly patients admitted for acute coronary syndromes (ACS) was associated with higher risk of mortality.


We used the data from a prospective, open, ongoing cohort of patients≥75 years old admitted for ACS to a tertiary centre. Cognitive impairment (CogI) was defined by delirium detected by the Confusion Assessment Method or an abnormal Mini Mental State Examination score. A Cox model adjusted on predefined correlates of mortality was used to assess the relationship between CogI and 1-year mortality.


Six-hundred consecutive patients with mental status assessment within 48 hours after admission were included. CogI was identified in 172 (29%) patients among whom 153 (25.5%) had an abnormal Mini Mental State Evaluation and 19 (3.2%) delirium. Death occurred in 49 (28.6%) patients with and 43 (10.5%) patients without CogI at 1 year. There was a significant association between CogI and 1-year mortality (adjusted-HR 2.4, 95% CI 1.53 to 3.62), p<0.001) independent of other covariables. CogI was also independently associated with higher rates of in-hospital bleeding and mortality as well as 3-month rates of all-cause, cardiovascular-related and heart failure-related rehospitalisation.


CogI detected by simple bedside tests in patients≥75 admitted for ACS is associated with an increased risk of 1-year mortality and 3 month rehospitalisation independent of other correlates of poor outcome.


acute coronary syndrome; cognitive impairment; death; delirium; elderly; outcome

Conflict of interest statement

Competing interests: Thelogistics and management of our cohorts are supported by grants from Biosensors, Medtronic and Boston Scientific.

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