In‐hospital outcomes of very elderly patients (85 years and older) undergoing percutaneous coronary intervention

Appleby, Clare; Ivanov, Joan; Mackie, Karen; Džavík, Vladimir; Overgaard, Christopher B.

doi:10.1002/ccd.22729

Cited by 22 publications

(14 citation statements)

References 30 publications

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“…Because of increased in-hospital mortality and complication rates, frail, complex older patients represent a high-risk cohort,29 whose short-term and long-term outcomes after PCI do not rely purely on cardiologic variables 30. For these reasons, their treatment requires a combination of the highest possible technical skills and of balanced, expert clinical judgment.…”

Section: Discussionmentioning

confidence: 99%

Decreased usage and increased effectiveness of percutaneous coronary intervention in complex older patients with acute coronary syndromes

Bari

Balzi²,

Fracchia

et al. 2014

Heart

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Section: Discussionmentioning

confidence: 99%

Decreased usage and increased effectiveness of percutaneous coronary intervention in complex older patients with acute coronary syndromes

Bari

Balzi²,

Fracchia

et al. 2014

Heart

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“…6 Particularly among individuals treated with percutaneous coronary intervention, advanced age has been directly associated with contrastinduced nephropathy, stroke/transient ischemic attack, and access-site and other vascular complications. 7,8 As a result of these increased risks of complications from medical and invasive therapies in the elderly, it is particularly important that accurate risk assessment tools are used to identify the highest-risk patients in whom the risk/benefit will be favorable for aggressive management for ACS.…”

Section: Influence Of Age On Acs Presentation and Outcomesmentioning

confidence: 99%

B‐type Natriuretic Peptides in Acute Coronary Syndromes: Implications in an Aging Population

Krim

Vivo

Lemos³

2012

Clinical Cardiology

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B-type natriuretic peptide (BNP) and N-terminal-proBNP (NT-proBNP) are increasingly recognized as prognostic markers in patients with acute coronary syndrome (ACS). The need for novel and more effective tools for risk assessment cannot be more emphasized than in older patients with ACS given their atypical presentation, multiple comorbidities, and higher risk for mortality and morbidity. Accurate interpretation of B-type NP values in older patients with ACS, however, may be confounded by several aging-related physiologic changes. Advanced age, reduction in body mass, and kidney function and anemia have been associated with higher BNP and NT-proBNP concentrations, and may create challenges with interpreting NP levels in the elderly. This review highlights the need to better understand the physiology of BNP and NT-proBNP in older individuals and their prognostic value in older patients with ACS. IntroductionThe prognostic role of B-type natriuretic peptide (BNP) and N-terminal-proBNP (NT-proBNP) in acute coronary syndromes (ACS) remains the subject of vigorous investigation reflecting the growing interest in improving risk stratification strategies for affected patients. While a compelling body of evidence demonstrates that these biomarkers independently predict adverse outcomes, a few issues of uncertainty limit their routine use in clinical decision making. One is the question of whether existing evidence can be extrapolated to the older population. This is an important issue as approximately 82% of deaths from coronary artery disease (CAD) occur in individuals age 65 or older. 1 Fundamental to examining the value of BNP and NT-proBNP in older persons with CAD is identifying aging-related factors that may influence their levels. This review summarizes current literature describing the value of these biomarkers in older patients with ACS. The relationship of BNP and NT-proBNP with advanced age and its associated physiologic alterations is also reviewed.

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“…Apart from isolated case reports and single center experiences with very small patient cohorts, few data on the results of PCI in nonagenarians are available . The lack of evidence‐based data regarding treatment strategies in this high‐risk subpopulation may cause underutilization of effective therapies .…”

Section: Introductionmentioning

confidence: 99%

Outcomes after primary percutaneous coronary intervention in octogenarians and nonagenarians with ST‐segment elevation myocardial infarction: From the Western Denmark heart registry

Antonsen

Jensen

Terkelsen

et al. 2013

Cathet Cardio Intervent

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In‐hospital outcomes of very elderly patients (85 years and older) undergoing percutaneous coronary intervention

Cited by 22 publications

References 30 publications

Decreased usage and increased effectiveness of percutaneous coronary intervention in complex older patients with acute coronary syndromes

Decreased usage and increased effectiveness of percutaneous coronary intervention in complex older patients with acute coronary syndromes

B‐type Natriuretic Peptides in Acute Coronary Syndromes: Implications in an Aging Population

Outcomes after primary percutaneous coronary intervention in octogenarians and nonagenarians with ST‐segment elevation myocardial infarction: From the Western Denmark heart registry

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