Predictors of in‐hospital mortality in octogenarian patients who underwent primary percutaneous coronary intervention after ST segment elevated myocardial infarction

İpek, Göktürk; Kurmuş, Özge; Köseoğlu, Cemal; Onuk, Tolga; Güngör, Barış; Kırbaş, Özgür; Karataş, Mehmet Baran; Keskin, Muhammed; Börklü, Edibe Betül; Hayıroğlu, Mert İlker; Tanik, Ozan; Öz, Ahmet; Bolca, Osman

doi:10.1111/ggi.12759

Cited by 6 publications

(5 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…36 They are also independent predictive factors, along with HF, of higher hospital mortality in octogenarian elderly submitted to percutaneous coronary intervention after suffering acute myocardial infarction. 37 The results presented in this study show that in older people, disabilities/vitamin D insufficiency was strongly associated with increased risk of HF.…”

Section: Discussionmentioning

confidence: 54%

Association between vitamin D deficiency and heart failure risk in the elderly

Porto

Silva

Luz³

et al. 2017

ESC Heart Failure

View full text Add to dashboard Cite

AimsThe aim of this study was to evaluate the association between vitamin D deficiency and risk of heart failure in elderly patients of cardiology outpatient clinics.Methods and resultsA cross‐sectional study with an analytical approach was employed. Clinical data were collected from the elderly from August 2015 to February 2016. The dependent variable was the risk of heart failure; the independent variable was vitamin D deficiency; and intervening factors were age, gender, education, ethnicity, hypertension, diabetes mellitus, hypothyroidism, renal failure, dementia, stroke, dyslipidaemia, depression, smoking, alcoholism, obesity, andropause, and cardiac arrhythmia. To analyse the association between vitamin D deficiency and risk of heart failure, we used the bivariate logistic analysis, followed by analysis through the multivariate logistic regression model. Of the 137 elderly, the study found the following: women (75.9%); overweight (48.2%); obese (30.6%); increase in the index waist/hip (88.3%); dyslipidaemia (94.2%) and hypertension (91.2%); coronary artery disease (35.0%); and 27.7% with cardiac arrhythmia or left ventricular hypertrophy. Sixty‐five per cent of the elderly were deficient in vitamin D. The risk of heart failure was significantly associated with vitamin D deficiency [odds ratio (OR): 12.19; 95% confidence interval (CI) = 4.23–35.16; P = 0.000], male gender (OR: 15.32; 95% CI = 3.39–69.20, P = 0.000), obesity (OR: 4.17; 95% CI = 1.36–12.81; P = 0.012), and cardiac arrhythmia (OR: 3.69; 95% CI = 1.23–11.11; P = 0.020).ConclusionsThere was a high prevalence of vitamin D deficiency in the elderly, and the evidence shows a strong association between vitamin D deficiency and increased risk of heart failure in this population.

show abstract

Section: Discussionmentioning

confidence: 54%

Association between vitamin D deficiency and heart failure risk in the elderly

Porto

Silva

Luz³

et al. 2017

ESC Heart Failure

View full text Add to dashboard Cite

show abstract

“…More recent reports from the European and American registries continue to underline how high multivessel CAD is in elderly patients (aged 75 years and older), with prevalence setting at around 50–60% when a stenosis of more than 70% is found in at least two vessels [ 11 , 12 ] (Table 1 , Ref. [ 7 , 8 , 9 , 10 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ]).…”

Section: Resultsmentioning

confidence: 99%

“…Cardiogenic shock, with a low left ventricle ejection fraction (LVEF), heart failure, hemodynamic instability, higher Killip class, low blood pressure at admission, anterior MI, use of protein IIb/IIIa inhibitors, ventricular arrhythmias, acute stent thrombosis, need of temporary cardiac pacing and low TIMI flow grade after procedure seemed to be the independent factors that most conditioned in-hospital and 30 days mortality despite, what were deemed to be successful PCI [ 28 , 33 , 34 , 35 ].…”

Section: Resultsmentioning

confidence: 99%

Unsolved Questions in the Revascularization of Older Myocardial Infarction Patients with Multivessel Disease

Pavasini¹,

Sanguettoli²,

Zanarelli³

et al. 2022

Rev. Cardiovasc. Med.

View full text Add to dashboard Cite

Background:In cardiology, the global phenomenon of population ageing poses new major challenges, ranging from more comorbid and frail patients to the presence of complex, calcified and multiple coronary lesions. Considering that elderly patients are under-represented in randomized clinical trials (RCT), the aim of this systematic review is to summarize the current knowledge on the revascularization of the elderly patient with myocardial infarction and multivessel coronary artery disease. Methods: A systematic review following PRISMA guidelines has been performed. The search was conducted on Pubmed (Medline), Cochrane library, Google Scholar and Biomed Central databases between January and February 2022. We selected the articles focusing on patients hospitalized for myocardial infarction (MI) with multivessel disease and aged 75 years or older. A total of 36 studies have been included. Results: Multivessel coronary artery disease is present in around 50-60% of older patients with MI. The in-hospital mortality rate of patients older than 75 years is double compared to their younger counterpart, and the most prevalent complications after revascularization are bleeding and renal failure. In the treatment of patients with ST elevation MI (STEMI), primary percutaneous coronary intervention should be the first choice over fibrinolysis. However, it is not clear whether this population would benefit from complete revascularization or not. In patients with non-ST elevation MI (NSTEMI), an invasive approach with either percutaneous coronary intervention or coronary artery bypass graft may be chosen, but a conservative strategy is also accepted. There are no data from large trials about the comparison of possible revascularization strategies in NSTEMI patients. Conclusions: This systematic review shows that this field of research lacks randomized clinical trials to guide revascularization strategy in older STEMI or NSTEMI patients with MI. New results are expected from ongoing trials.

show abstract

“…ФВ ЛЖ < 40% ассоциируется с повышением уровня госпитальной летальности [14]. В работе, включившей 2353 пациента с ИМпST, ФВ < 30%, наряду с многососудистым поражением коронарных артерий, передней локализацией ИМ, желудочковыми тахиаритмиями и баллом по шкале Killip ≥ 2, выступала независимым предиктором госпитальной летальности [15].…”

Section: Discussionunclassified

Comparison of in-hospital and long-term mortality and assessment of their predictors in patients with myocardial infarction and unstable angina

Shchinova

Потехина

Dolgusheva

et al. 2023

Almanac of Clinical Medicine

View full text Add to dashboard Cite

Background: The extent of myocardial damage largely determines both in-hospital and long-term mortality in patients with acute coronary syndrome. According to the literature, the in-hospital and long-term mortality rates in patients with unstable angina (UA) are lower than those in the patients with myocardial infarction (MI). Aim: To evaluate the in-hospital and long-term mortality rates and their predictors in patients undergoing in-patient treatment for acute coronary syndrome (MI and UA) in the regional cardiovascular center with the service territory of 1 million persons. Materials and methods: This retrospective registry study enrolled 1130 patients (715 [63.3%] men, 415 [36.7%] women) who were treated for UA and MI in the regional cardiovascular center in 2019. Based on the discharge diagnosis, the patients were divided into two groups: patients with MI (n = 766) and those with an UA episode (n = 364). The in-hospital and delayed mortality rates, as well as their predictors, were analyzed in both groups. The mean duration of the follow-up was 17.8 3.6 months. Results: The in-hospital mortality in patients with confirmed MI was 11.1% (85 patients) versus 0.27% (1 patient) in the UA patients (p 0.001). The independent predictors of in-hospital mortality in MI patients were a decreased left ventricular ejection fraction (LV EF) (odds ratio (OR) 0.9021, 95% confidence interval (CI) 0.82090.9914, p = 0.0324), chronic kidney disease C3a and above (OR 9.3205, 95% CI 2.670632.5283, p = 0.0005), and the extension of coronary involvement at coronary angiography (OR 1.3526, 95% CI 1.06670.0127, p = 0.0127). The long-term mortality in MI patients was 10.4% (72 patients) with no significant difference from that in UA patients (9.9%, 36 patients, p = 0.76). The independent predictors of long-term mortality after MI were older age (OR 1.12, 95% CI 1.011.22, p = 0.0052), chronic kidney disease C3a and above (OR 2.3375, 95% CI 1.13924.7963, p = 0.0206), decreased EF (OR 0.8895, 95% CI 0.730.99, p = 0.0364), atrial fibrillation on admission (OR 3.1462, 95% CI 1.35107.3268, p = 0.0079), and diabetes mellitus (OR 2.3163, 95% CI 1.25524.2744, p = 0.0072). In the UA patients, the predictors of the long-term mortality were a decrease in LV EF (OR 0.9139, 95% CI 0.86830.9619, p = 0.0006) and in blood hemoglobin level (OR 0.9729, 95% CI 0.95440.9917, p = 0.0050). Conclusion: The in-hospital mortality in UA patients is lower than that in MI patients, with comparable long-term mortality. This indicates the need of active follow-up of the patients with past UA, irrespective of the endovascular assessment and intervention.

show abstract

Predictors of in‐hospital mortality in octogenarian patients who underwent primary percutaneous coronary intervention after ST segment elevated myocardial infarction

Abstract: Acute stent thrombosis, anterior MI, heart failure, low ejection fraction, ventricular arrhythmias and multivessel disease are the independent risk factors for in-hospital mortality among octogenarian patients after primary PCI. Geriatr Gerontol Int 2017; 17: 584-590.

Cited by 6 publications

References 23 publications

Association between vitamin D deficiency and heart failure risk in the elderly

Association between vitamin D deficiency and heart failure risk in the elderly

Unsolved Questions in the Revascularization of Older Myocardial Infarction Patients with Multivessel Disease

Comparison of in-hospital and long-term mortality and assessment of their predictors in patients with myocardial infarction and unstable angina

Contact Info

Product

Resources

About