Stress cardiac magnetic resonance for mortality prediction and decision-making: registry of 2496 elderly patients with chronic coronary syndrome

MRI Investigation of the Differential Impact of Left Ventricular Ejection Fraction After Myocardial Infarction in Elderly vs. Nonelderly Patients to Predict Readmission for Heart Failure

“…There is no well-established cut-off value to define elderly population, so a 70-year cutoff was selected in accordance with our previous experience. 7,37 A relatively low incidence of AHF was recorded in our population, although concordant with contemporary registries. Furthermore, several biochemical and clinical variables such as geriatric assessment, frailty evaluation, and other imaging parameters which could have played a role in patient prognosis were not included in the registry.…”

“…Referral and survival bias cannot be excluded due to the observational nature of our study, and patients referred for MRI may not be entirely representative of the whole STEMI population. There is no well‐established cut‐off value to define elderly population, so a 70‐year cutoff was selected in accordance with our previous experience 7,37 . A relatively low incidence of AHF was recorded in our population, although concordant with contemporary registries.…”

“…4,5 Moreover, age-related factors such as comorbidities and geriatric syndromes further aggravate the prognosis of STEMI patients. 6,7 AHF is one of the most frequent complications after STEMI 8 and substantially worsens long-term prognosis in contemporary registries. 9,10 Identifying patients at higher risk of this event is important for prescribing tailored guideline-directed medical therapies and organizing structured follow-up healthcare routes for early detection and treatment of decompensations.…”

“…Besides often presenting with atypical ischemic symptoms and altered baseline ECG that complicates STEMI identification, elderly patients also have a 4‐fold increased risk of death or rehospitalization for acute heart failure (AHF) 4,5 . Moreover, age‐related factors such as comorbidities and geriatric syndromes further aggravate the prognosis of STEMI patients 6,7 …”

Prognostic value of cardiac magnetic resonance early after ST-segment elevation myocardial infarction in older patients

“…Older STEMI patients represent a subset with several particularities, such as increased risk of HF or mechanical complications [5,25], more delay intervention, increased comorbidity [5][6][7], higher prevalence of previous history of IHD and multivessel involvement [5,26,27], and attenuated benefit of revascularization strategies [28]. While the prognostic value of stress CMR has been studied in older patients with chronic coronary syndrome [29], confirmation of whether CMR can be prognostically valuable in older STEMI patients is also desirable.…”