Modalities of treatment and 30-day outcomes of unselected patients older than 75 years with acute ST-elevation myocardial infarction: data from the BLITZ study

Luca, Leonardo De; Bolognese, Leonardo; Casella, Gianni; Savonitto, Stefano; Gonzini, Lucio; Chiara, Antonio Di; Servi, Stefano De; Notaristefano, Salvatore; Valagussa, L; Maggioni, Aldo P.; Chiarella, Francesco

doi:10.2459/jcm.0b013e32830eb6eb

Cited by 6 publications

(3 citation statements)

References 41 publications

(57 reference statements)

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“…This finding is in agreement with many previous studies showing that evidence-based therapies for secondary and tertiary prevention of acute coronary syndromes (e.g., statins, anti-platelet agents, angiotensinconverting enzyme inhibitors or angiotensin-receptor blockers, β-blockers) were increasingly used among the elderly. [24][25][26][27][28][29][30] Independently of procedure use, this increasing use of medications surely had a great impact on improvements in survival.…”

Section: Researchmentioning

confidence: 99%

Temporal trends in revascularization and outcomes after acute myocardial infarction among the very elderly

Pagé¹,

Doucet²,

Eisenberg³

et al. 2010

Canadian Medical Association Journal

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Section: Researchmentioning

confidence: 99%

Temporal trends in revascularization and outcomes after acute myocardial infarction among the very elderly

Pagé¹,

Doucet²,

Eisenberg³

et al. 2010

Canadian Medical Association Journal

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“…Furthermore, the current European guidelines [ 44 ] on the treatment of STEMI patients do not suggest an upper age limit with respect to reperfusion, especially for PCI. Despite the evidence, up until 2010, in patients aged more than 75, PCI was still underperformed either after STEMI or as PCI rescue after failed fibrinolysis, leading to a higher mortality at 30 days [ 13 , 14 , 45 ]. However, more contemporary data showed how PCI is feasible and without complications in the majority of older patients showing a success rate reaching 99% [ 15 ].…”

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.

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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.

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“…; De Luca et al. ; Eagle et al. ) and over 40 percent of reperfused patients received it outside the recommended time window (Eagle et al.…”

Section: Discussionmentioning

confidence: 99%

Reporting of Quality Indicators and Improvement in Hospital Performance: The P.Re.Val.E. Regional Outcome Evaluation Program

Renzi¹,

Sorge

Fusco³

et al. 2012

Health Services Research

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Modalities of treatment and 30-day outcomes of unselected patients older than 75 years with acute ST-elevation myocardial infarction: data from the BLITZ study

Abstract: In a nationwide clinical practice, the vast majority of patients older than 75 years presenting with ST-elevation myocardial infarction does not receive any early reperfusion treatment and presents a significant incidence of major clinical events at 30 days.

Cited by 6 publications

References 41 publications

Temporal trends in revascularization and outcomes after acute myocardial infarction among the very elderly

Temporal trends in revascularization and outcomes after acute myocardial infarction among the very elderly

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

Reporting of Quality Indicators and Improvement in Hospital Performance: The P.Re.Val.E. Regional Outcome Evaluation Program

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