The effects of percutaneous coronary intervention on mortality in elderly patients with non-ST-segment elevation myocardial infarction undergoing coronary angiography

Abstract

Introduction Although it is recommended that elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI) should undergo an assessment for invasive revascularization, these patients undergo fewer coronary interventions despite the current guidelines. The aim of the study is to evaluate the effectiveness of percutaneous coronary intervention on all-cause mortalities monthly and annually in the population. Methods Three hundred and twenty-four patients with NSTEMI aged 65 years or older who underwent coronary angiography and treated with conservative strategy or percutaneous coronary intervention were included in the study. All demographic and clinical characteristics of the patients were recorded and one-month and one-year follow-up results were analysed. Results Two hundred eight cases (64.19%) were treated with percutaneous coronary intervention and 116 cases (35.81%) of the participant were treated with conservative methods. The mean age of the participants was 75.41 ± 6.65 years. The treatment strategy was an independent predictor for the mortality of one-year (HR: 1.965). Furthermore, Killip class ≥2 (HR:2.392), Left Ventricular Ejection Fraction (HR:2.637) and renal failure (HR: 3.471) were independent predictors for one-year mortality. Conclusion The present study has revealed that percutaneous coronary intervention was effective on one-year mortality in NSTEMI patients over the age of 65. It is considered that percutaneous coronary intervention would decrease mortality in these patients but it should be addressed in larger population studies.

Effectiveness of LODS, OASIS, and SAPS II to predict in-hospital mortality for intensive care patients with ST elevation myocardial infarction

“…Navicat Premium software (v15.0) was used to extract the following data of the included patients from MIMIC-IV database (v1.0): age, gender, length of ICU stay, length of hospital stay, coexisting comorbidities (congestive heart failure, peripheral vascular disease, cerebrovascular disease, chronic pulmonary disease, rheumatic disease, peptic ulcer disease, liver disease, diabetes, renal disease, malignant cancer, hypertension, and obesity), laboratory tests (red blood cell, white blood cell, platelets, hemoglobin, anion gap, blood urea nitrogen, creatinine, and INR), vital signs (heart rate, systolic blood pressure, diastolic blood pressure, mean blood pressure, respiratory rate, temperature, and SpO 2 ), and scoring systems (LODS, OASIS, and SAPS II). PCI is the standard interventional treatment modality for patients with STEMI 12 , also was proved to be effective on one-year mortality in non-ST-segment elevation myocardial infarction (NSTEMI) patients 13 . Approximately 20–30% of patients are not eligible for PCI and require surgical intervention, that is, coronary artery bypass grafting (CABG) 14 , 15 .…”