Primary Angioplasty in Patients Older Than 75 Years. Profile of Patients and Procedures, Outcomes, and Predictors of Prognosis in the ESTROFA IM + 75 Registry

Brugaletta, Salvatore; Baz, José Antonio; Prado, Armando Pérez de; Palop, Ramón Lopéz; Cid, Belén; Camarero, Tamara García; Diego, Alejandro; Carlos, Federico Gimeno de; Díaz, José; Sanchís, Juan; Alfonso, Fernándo; Blanco, Roberto; Botas, Javier; Cuartero, Javier Navarro; Moreu, José; Bosa, Francisco; Valle, José M. Vegas; Elı́zaga, Jaime; Arrebola, Antonio L.; Arroyo, José R. Ruiz; Hernández-Hernández, Felipe; Salvatella, Neus; Monteagudo, Marta; Jaume, Alfredo Gómez; Carrillo, Xavier; Reyes, Roberto Martín; Lozano, Fernando; Rumoroso, José Ramón; Andraka, Leire; Domínguez, Antonio

doi:10.1016/j.rec.2016.06.012

Cited by 15 publications

(16 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, we noted high rates of IR in the older group (64%). This finding is consistent with a recent multicentric study that included 3576 STEMI patients older than 75 years, in which 55.4% of patients showed MVD with a rate of IR of 35% . In this sense and with this high rate of IR, the role of performing ischaemia stress test seems to be decisive; however, it is important to highlight that the documentation of ischaemia using functional testing to target revascularization was performed only in 7 (6.3%) MVD‐STEMI patients ≥75 years, despite being a recommendation in current clinical guidelines and in contrast to MVD‐STEMI patients <75 years where ischaemia stress tests were used in more than 25% of the patients.…”

Section: Discussionsupporting

confidence: 87%

Long‐term outcomes and predictors of morbi‐mortality according to age in stemi patients with multivessel disease: Impact of an incomplete revascularization

Rúmiz

Berenguer

Vilar

et al. 2018

Cathet Cardio Intervent

View full text Add to dashboard Cite

This study confirms the relevant prevalence of MVD in STEMI patients, as well as the difference in outcomes of an IR strategy between both age-groups, being only independently associated with MACE in younger patients. This finding supports that a routine complete revascularization (CR) strategy seems to be the best therapeutic option in younguer patients, whereas in the elderly population may not confer a clear clinical benefit during a long-term follow-up.

show abstract

Section: Discussionsupporting

confidence: 87%

Long‐term outcomes and predictors of morbi‐mortality according to age in stemi patients with multivessel disease: Impact of an incomplete revascularization

Rúmiz

Berenguer

Vilar

et al. 2018

Cathet Cardio Intervent

View full text Add to dashboard Cite

show abstract

“…Patients aged ≥75 years old with non-STEMI have received special attention in recent years, 13 14 but more rare, and in some cases inconclusive, are the studies in patients with STEMI, particularly assessing the use of P-PCI. 15 If we take into account the important Spanish multicentre studies published in the first decade of this century, only the TRIANA 16 clinical trial and the ESTROFA 17 registry included patients aged >75 years old who presented with STEMI and in whom P-PCI was performed. TRIANA showed a trend towards better survival when P-PCI was used compared with fibrinolysis, and ESTROFA described that elderly STEMI patients had a high prevalence of renal failure and multivessel disease.…”

Section: Discussionmentioning

confidence: 99%

Benefit of primary percutaneous coronary interventions in the elderly with ST segment elevation myocardial infarction

et al. 2020

Self Cite

View full text Add to dashboard Cite

ObjectivePrimary percutaneous coronary intervention (P-PCI) has demonstrated its efficacy in patients with ST segment elevation myocardial infarction (STEMI). However, patients with STEMI ≥75 years receive less P-PCI than younger patients despite their higher in-hospital morbimortality. The objective of this analysis was to determine the effectiveness of P-PCI in patients with STEMI ≥75 years.MethodsWe included 979 patients with STEMI ≥75 years, from the ATención HOspitalaria del Síndrome coronario study, a registry of 8142 consecutive patients with acute coronary syndrome admitted at 31 Spanish hospitals in 2014–2016. We calculated a propensity score (PS) for the indication of P-PCI. Patients that received or not P-PCI were matched by PS. Using logistic regression, we compared the effectiveness of performing P-PCI versus non-performance for the composite primary event, which included death, reinfarction, acute pulmonary oedema or cardiogenic shock during hospitalisation.ResultsOf the included patients, 81.5 % received P-PCI. The matching provided two groups of 169 patients with and without P-PCI. Compared with its non-performance, P-PCI presented a composite event OR adjusted by PS of 0.55 (95% CI 0.34 to 0.89).ConclusionsReceiving a P-PCI was significantly associated with a reduced risk of major intrahospital complications in patients with STEMI aged 75 years or older.

show abstract

“…According to current guidelines, primary PCI performed <120 min since the first medical contact is the treatment of choice, irrespective of age. PCI is superior to fibrinolysis in reducing mortality, reinfarction, or stroke [ 18 ]. It is recommended to use radial access and stenting with new-generation drug-eluting stents, since this strategy is associated with fewer events [ 18 , 19 ].…”

Section: St-segment Elevation Myocardial Infarction (Stemi) Patientsmentioning

confidence: 99%

“…PCI is superior to fibrinolysis in reducing mortality, reinfarction, or stroke [ 18 ]. It is recommended to use radial access and stenting with new-generation drug-eluting stents, since this strategy is associated with fewer events [ 18 , 19 ]. Otherwise, and in the absence of contraindications, fibrinolytic therapy is recommended, always within the first 12 h since symptom onset, and providing the highest benefit when administered within the first two hours.…”

Section: St-segment Elevation Myocardial Infarction (Stemi) Patientsmentioning

confidence: 99%

Acute Coronary Syndrome in the Older Patient

García‐Blas

Cordero

Díez‐Villanueva

et al. 2021

JCM

View full text Add to dashboard Cite

Coronary artery disease is one of the leading causes of morbidity and mortality, and its prevalence increases with age. The growing number of older patients and their differential characteristics make its management a challenge in clinical practice. The aim of this review is to summarize the state-of-the-art in diagnosis and treatment of acute coronary syndromes in this subgroup of patients. This comprises peculiarities of ST-segment elevation myocardial infarction (STEMI) management, updated evidence of non-STEMI therapeutic strategies, individualization of antiplatelet treatment (weighting ischemic and hemorrhagic risks), as well as assessment of geriatric conditions and ethical issues in decision making.

show abstract

Primary Angioplasty in Patients Older Than 75 Years. Profile of Patients and Procedures, Outcomes, and Predictors of Prognosis in the ESTROFA IM + 75 Registry

Cited by 15 publications

References 34 publications

Long‐term outcomes and predictors of morbi‐mortality according to age in stemi patients with multivessel disease: Impact of an incomplete revascularization

Long‐term outcomes and predictors of morbi‐mortality according to age in stemi patients with multivessel disease: Impact of an incomplete revascularization

Benefit of primary percutaneous coronary interventions in the elderly with ST segment elevation myocardial infarction

Acute Coronary Syndrome in the Older Patient

Contact Info

Product

Resources

About