Age‐Related Differences in Reperfusion Therapy and Outcomes for ST‐Segment Elevation Myocardial Infarction

Turk, Julien; Fourny, Magali; Yayehd, Komlavi; Picard, Nicolas; Ageron, François-Xavier; Boussat, Bastien; Belle, Loïc; Vanzetto, Gérald; Puymirat, Étienne; Labarère, José; Debaty, Guillaume

doi:10.1111/jgs.15383

Cited by 13 publications

(13 citation statements)

References 40 publications

(111 reference statements)

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“…The rationale, data collection methods, verification procedures, and primary outcomes of this registry have been reported in detail elsewhere. 21,22 In this observational study, no specific intervention was assigned to participants. All diagnostic testing, procedures, and medication ordering were performed at the discretion of attending physicians.…”

Section: Methodsmentioning

confidence: 99%

“…The median distance and driving time from each community hospital to the closest percutaneous coronary intervention (PCI) center were 63 km (range, 4.5–132 km) and 43 min (range, 10–88 min), respectively. The rationale, data collection methods, verification procedures, and primary outcomes of this registry have been reported in detail elsewhere 21,22 . In this observational study, no specific intervention was assigned to participants.…”

Section: Methodsmentioning

confidence: 99%

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Sex differences in coronary artery lesions and in‐hospital outcomes for patients with ST‐segment elevation myocardial infarction under the age of 45

Vautrin

Jean

Fourny

et al. 2019

Cathet Cardio Intervent

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Objective: We aimed to compare baseline characteristics, coronary angiogram findings, and in-hospital outcomes between female and male patients with ST-segment elevation myocardial infarction (STEMI) under the age of 45 years. Background: Although sex differences in risk factor profile have been documented for young patients with STEMI, limited data exist on the prevalence of spontaneous coronary artery dissection in these patients. Methods: As part of an ongoing hospital-based registry of suspected STEMI, we analyzed the original data for 51 women under the age of 45 years matched with 93 men of similar age who underwent coronary angiography at two percutaneous coronary intervention centers, between January 2003 and December 2012. Two interventional cardiologists independently reviewed coronary angiograms for all patients. Results: The mean age for all patients was 39 years (range, 24-44) and the overall prevalence of cigarette smoking, dyslipidemia, hypertension, and diabetes mellitus were 70, 32, 13, and 4%, respectively. Young women were more likely to present with spontaneous coronary artery dissection (22 vs. 3%, p = .003) and more of them experienced reinfarction during the hospital course (15 vs. 1%, p = .01). The inhospital mortality rate was 2% for both sexes. Conclusions: Spontaneous coronary artery dissection is an important cause of myocardial infarction in young female adults, accounting for 22% (95% confidence interval, 11-35%) of women with STEMI under the age of 45 years. The true prevalence of spontaneous coronary artery dissection might even be underestimated, because of the limited availability of advanced imaging techniques at the time of our study.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Sex differences in coronary artery lesions and in‐hospital outcomes for patients with ST‐segment elevation myocardial infarction under the age of 45

Vautrin

Jean

Fourny

et al. 2019

Cathet Cardio Intervent

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“…Близько 80 % випадків цього невідкладного стану зустрічається в осіб віком понад 60 років [5]. Окрім того, у низці досліджень відзначено, що в літніх пацієнтів проміжок між виникненням симптомів і початком коронарної реваскуляризації довший, ніж у хворих віком до 60 років [6,7].…”

Section: вступunclassified

Кардиопротекторный Эффект Нитроглицерина При Неотложной Чрескожной Эндоваскулярной Реваскуляризации Миокарда У Пациентов Пожилого Возраста С Острым Коронарным Синдромом

Furkalo¹,

Лоскутов²,

Dziuba³

et al. 2021

ЕМ

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Кардіопротективний ефект нітрогліцерину при невідкладній черезшкірній ендоваскулярній реваскуляризації міокарда в пацієнтів похилого віку з гострим коронарним синдромом Резюме. Актуальність. У 2018 році в США ішемічна хвороба серця була причиною летальних випадків у 43,8 % хворих і посіла лідируюче місце у структурі смертності від патології серцево-судинної системи. Золотим стандартом невідкладної допомоги при гострому коронарному синдромі (ГКС) вважається ендоваскулярна реваскуляризація коронарних артерій. Суттєвим ускладненням навіть технічно коректної процедури може стати ішемічно-реперфузійне ураження міокарда. Однією з груп препаратів, що застосовуються з метою кардіопротекції, є нітрати, найпоширеніший з яких-нітрогліцерин. Не має одностайної думки щодо доцільності та ефективності використання цього препарату з метою кардіопротекції через його переважний вплив на венозне судинне русло та розвиток толерантності при тривалому введенні. Мета: дослідити ефективність кардіопротективного ефекту нітрогліцерину у хворих похилого віку з ГКС під час ендоваскулярної реваскуляризації міокарда.

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“…Advanced age is associated with increased mortality in STEMI patients, however, younger patients still have a considerable mortality [9] , [10] . Nevertheless, the mortality in patients with acute myocardial infarction increases exponentially with increasing age with a 5 times higher mortality in octogenarians [11] .…”

Section: Introductionmentioning

confidence: 99%

Impact of age on reperfusion success and long-term prognosis in ST-segment elevation myocardial infarction – A cardiac magnetic resonance imaging study

Topal

Ahtarovski

Lønborg

et al. 2021

IJC Heart & Vasculature

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Background Coronary collateral circulation and conditioning from remote ischemic coronary territories may protect culprit myocardium in the elderly, and younger STEMI patients could suffer from larger infarcts. We evaluated the impact of age on myocardial salvage and long-term prognosis in a contemporary STEMI cohort. Methods Of 1603 included STEMI patients 807 underwent cardiac magnetic resonance. To assess the impact of age on infarct size and left ventricular ejection fraction (LVEF) as well as the composite endpoint of death and re-hospitalization for heart failure we stratified the patients by an age cut-off of 60 years. Results Younger STEMI patients had smaller final infarcts (10% vs. 12%, P = 0.012) and higher final LVEF (60% vs. 58%, P = 0.042). After adjusting for multiple potential confounders age did not remain significantly associated with infarct size and LVEF. During 4-year follow-up, the composite endpoint occurred less often in the young (3.2% vs. 17.2%; P < 0.001) with a univariate hazard ratio of 5.77 (95% CI, 3.75–8.89; p < 0.001). Event estimates of 4 subgroups (young vs. elderly and infarct size beyond vs. below median) showed a gradual increase in the occurrence of the composite endpoint depending on both age and acute infarct size (log-rank p < 0.001). Conclusion Having a STEMI after entering the seventh decade of life more than quadrupled the risk of future death or re-hospitalization for heart failure. Risk of death and re-hospitalization depended on both advanced age and infarct size, albeit no substantial difference was found in infarct size, LVEF and salvage potential between younger and elderly patients with STEMI.

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Age‐Related Differences in Reperfusion Therapy and Outcomes for ST‐Segment Elevation Myocardial Infarction

Abstract: Older adults meeting contemporary eligibility criteria for reperfusion therapy continue to receive delayed reperfusion therapy and experience higher mortality than their younger counterparts.

Cited by 13 publications

References 40 publications

Sex differences in coronary artery lesions and in‐hospital outcomes for patients with ST‐segment elevation myocardial infarction under the age of 45

Sex differences in coronary artery lesions and in‐hospital outcomes for patients with ST‐segment elevation myocardial infarction under the age of 45

Impact of age on reperfusion success and long-term prognosis in ST-segment elevation myocardial infarction – A cardiac magnetic resonance imaging study

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