Factors associated with use of percutaneous coronary intervention among elderly patients presenting with ST segment elevation acute myocardial infarction (STEMI): Results from the ISACS-TC registry

Câlmâc, Lucian; Батайла, Влад; Ricci, Beatrice; Vasiljević, Zorana; Kedev, Saško; Gustienė, Olivija; Trininic, Dijana; Knežević, Božidarka; Miličić, Davor; Dilić, Mirza; Manfrini, Olivia; Cenko, Edina; Badimon, Lina; Bugiardini, Raffaele; Scafa-Udriște, Alexandru; Tautu, O.; Dorobanțu, Maria

doi:10.1016/j.ijcard.2016.06.227

Cited by 13 publications

(8 citation statements)

References 41 publications

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“…Of these comorbidities, only hypertension and the absence of heart failure were relevant determinants of invasive intervention in our analysis of in-hospital AMIs. Interestingly, unlike one study that found that hypertension was associated with conservative treatment in out-of-hospital STEMIs [11], we found that it is associated with higher odds of using invasive intervention in patients with in-hospital AMIs. Another potential determinant for not treating patients with in-hospital AMIs invasively may be multi-comorbidity rather than the presence or absence of specific comorbidities.…”

Section: Discussioncontrasting

confidence: 99%

“…In addition, certain comorbidities (mentioned previously) are associated with the underutilization of invasive intervention [10][11][12]14,15]. Of these comorbidities, only hypertension and the absence of heart failure were relevant determinants of invasive intervention in our analysis of in-hospital AMIs.…”

Section: Discussionmentioning

confidence: 80%

“…Insights on the determinants of invasive intervention compared to conservative treatment were provided by studies that solely included out-of-hospital AMIs or did not distinguish between out-of-hospital and in-hospital AMIs. These studies [10][11][12][13][14][15] identified patient-related determinants of invasive intervention utilization such as younger age, male sex, and lower heart rate on admission, in addition to the absence of specific pre-existing comorbidities such as stroke, chronic kidney disease, heart failure, and dementia. Moreover, a diagnosis of ST-segment elevation (STEMI) was found to be a determinant of invasive intervention usage compared to non-ST-segment myocardial infarction (NSTEMI) [10,12].…”

Section: Introductionmentioning

confidence: 99%

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Comparison between Invasive Intervention and Conservative Treatment in Patients with In-Hospital Myocardial Infarctions: Results from the Regional Myocardial Infarction Registry of Saxony-Anhalt (RHESA) Study

Assaf,

Costa,

Efremov

et al. 2024

JCM

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Background/Objectives: In-hospital myocardial infarctions (AMIs) are less often treated with invasive intervention, compared to out-of-hospital AMIs. We aimed to identify the determinants of invasive intervention in patients with in-hospital AMIs and assess its association with mortality, compared to conservative treatment. Methods: This was a cross-sectional study of in-hospital AMIs in The Regional Myocardial Infarction Registry of Saxony-Anhalt. Patients’ characteristics and outcomes were compared based on the treatment strategy (invasive intervention vs. conservative treatment). Logistic regression was performed to assess the determinants of invasive intervention (vs. conservative treatment) and its association with 30-day mortality. Results: Nearly 67% of the patients (259/386) received invasive intervention, and the rest were treated conservatively. Those who were treated with an invasive intervention were younger and had a lower proportion of chronic heart failure than those treated conservatively. Age > 75 years compared to younger patients, pre-existing heart failure, and higher heart rate upon presentation were associated with lower odds of receiving invasive intervention. Hypertension (OR = 2.86, 95% CI [1.45–5.62]) and STEMI vs. NSTEMI (1.96, [1.10–3.68]) were associated with higher odds of invasive intervention. The adjusted odds of 30-day mortality were lower with invasive intervention compared to conservative treatment (0.25, [0.10–0.67]). Conclusions: One-third of the patients with in-hospital AMIs received conservative treatment. Younger age, absence of heart failure, lower heart rate, hypertension, and STEMI were determinants of invasive intervention usage. Invasive intervention had lower odds of 30-day mortality, but longitudinal studies are still needed to assess the efficacy of conservative vs. invasive strategies in in-hospital AMIs.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

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Comparison between Invasive Intervention and Conservative Treatment in Patients with In-Hospital Myocardial Infarctions: Results from the Regional Myocardial Infarction Registry of Saxony-Anhalt (RHESA) Study

Assaf,

Costa,

Efremov

et al. 2024

JCM

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“…In addition, it should be noted that only two thirds of older patients with STEMI either took PCI or thrombolytic therapy, and not more than one-half of them took primary PCI in this study, no matter whether among those with or without SMuRFs. This phenomenon has also been reported by other studies, 30 , 31 , 32 indicating a low rate of revascularization was a universal problem for the older population. How to improve revascularization rates in the older population is a priority for quality-of-care improvement research in the future.…”

Section: Discussionsupporting

confidence: 87%

Characteristics, Treatment, and In-Hospital Outcomes of Older Patients With STEMI Without Standard Modifiable Risk Factors

Zhao,

Zhou,

Zhao

et al. 2024

JACC: Asia

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“…Отказ от инвазивного лечения у пациентов старше 75 лет был связан с имеющимися факторами риска, тяжестью симптомов и поздней госпитализацией. Предикторами невыполнения коронарографии служили женский пол, наличие сопутствующих заболеваний и поздняя госпитализация [11].…”

Section: материалы и методыunclassified

The management of patients aged 90 years and older with ST-segment elevation myocardial infarction

Павлова

Хохлунов

Duplyakov

2023

Science and Innovations in Medicine

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Aim to study in-hospital outcomes in patients with ST-segment elevation myocardial infarction (STEMI) in the age group over 90 years old, depending on the treatment tactics. Material and methods. For the period of January, 2017 - December, 2020, in total 72 patients aged 90 were hospitalized in Samara Regional Clinical Cardiology Dispensary with STEMI: mean age 91.8 years (90-96), among them 49 women (68%). Patients were divided into two groups depending on the chosen treatment strategy. Group 1 included patients (n = 13) who underwent coronary angiography and primary percutaneous coronary intervention (pPCI), mean age 90.6 (90-91) years, 8 women (61.5%). Group 2 included patients who received coronary angiography and conservative treatment (n = 5) and only conservative treatment (n = 54), mean age 91.9 (91-96) years, 41 women (69.5%). Results. In terms of the incidence of pulmonary edema and cardiogenic shock, both groups were comparable, no statistically significant differences were found. In-hospital mortality among STEMI patients aged 90 years and older was higher in the conservative treatment group than in the invasive group (45.8% vs. 7.7%) (OR 10.12; 95% CI (1.2482 .96)). Conclusion. The results obtained in our study may indicate the advantage of the invasive strategy in the treatment of patients with STEMI over the age of 90 years. Further prospective studies based on the principles of evidence-based medicine are required.

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Factors associated with use of percutaneous coronary intervention among elderly patients presenting with ST segment elevation acute myocardial infarction (STEMI): Results from the ISACS-TC registry

Cited by 13 publications

References 41 publications

Comparison between Invasive Intervention and Conservative Treatment in Patients with In-Hospital Myocardial Infarctions: Results from the Regional Myocardial Infarction Registry of Saxony-Anhalt (RHESA) Study

Comparison between Invasive Intervention and Conservative Treatment in Patients with In-Hospital Myocardial Infarctions: Results from the Regional Myocardial Infarction Registry of Saxony-Anhalt (RHESA) Study

Characteristics, Treatment, and In-Hospital Outcomes of Older Patients With STEMI Without Standard Modifiable Risk Factors

The management of patients aged 90 years and older with ST-segment elevation myocardial infarction

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