National Trends and Outcomes of Percutaneous Coronary Intervention in Patients ≥70 Years of Age With Acute Coronary Syndrome (from the National Inpatient Sample Database)

Elbadawi, Ayman; Elgendy, Islam Y.; Ha, Le Dung; Mahmoud, Karim; Lenka, Jyotirmayee; Olorunfemi, Odunayo; Reyes, Amy; Ogunbayo, Gbolahan; Saad, Marwan; Abbott, J. Dawn

doi:10.1016/j.amjcard.2018.09.030

Cited by 45 publications

(24 citation statements)

References 21 publications

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“…Data from the NIS database was previously used to describe outcomes and trends of coronary artery disease in different patient population such as elderly or young patients. 11,12 Data from the NIS are de-identified, and hence, the current study was exempted from the institutional review board.…”

Section: Data Source and Study Populationmentioning

confidence: 99%

Age-Stratified Sex Disparities in Care and Outcomes in Patients With ST-Elevation Myocardial Infarction

Liu

Elbadawi

Elgendy

et al. 2020

The American Journal of Medicine

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Section: Data Source and Study Populationmentioning

confidence: 99%

Age-Stratified Sex Disparities in Care and Outcomes in Patients With ST-Elevation Myocardial Infarction

Liu

Elbadawi

Elgendy

et al. 2020

The American Journal of Medicine

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“…However, the use of exercise as part of regular treatment in healthcare vary largely 1. In recent years, the average age of patients admitted to the hospital for acute coronary syndromes (ACS) has significantly increased 2. Older patients with ACS show the highest risk of mobility limitation, sedentary behaviour and physical inactivity, further worsening short-term and mid-term prognosis 2 3.…”

Section: Introductionmentioning

confidence: 99%

“…In recent years, the average age of patients admitted to the hospital for acute coronary syndromes (ACS) has significantly increased 2. Older patients with ACS show the highest risk of mobility limitation, sedentary behaviour and physical inactivity, further worsening short-term and mid-term prognosis 2 3. Previous studies showed that traditional centre-based cardiac rehabilitation programmes effectively improve physical performance and outcomes after ACS.…”

Section: Introductionmentioning

confidence: 99%

Exercise intervention improves quality of life in older adults after myocardial infarction: randomised clinical trial

Campo¹,

Tonet

Chiaranda

et al. 2020

Heart

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ObjectiveTo establish the benefits of an early, tailored and low-cost exercise intervention in older patients hospitalised for acute coronary syndrome (ACS).MethodsThe study was a multicentre, randomised assessment of an exercise intervention in patients with ACS ≥70 years with reduced physical performance (as defined by the short physical performance battery (SPPB), value 4–9). The exercise intervention included four supervised sessions (1, 2, 3, 4 months after discharge) and home-based exercises. The control group attended a health education programme only. The outcomes were the 6-month and 1-year effects on physical performance, daily activities, anxiety/depression and quality of life. Finally, 1-year occurrence of adverse events was recorded.ResultsOverall, 235 patients with ACS (median age 76 (73–81) years) were randomised 1 month after ACS. Exercise and control groups were well balanced. Exercise intervention improved 6-month and 1-year grip strength and gait speed. Exercise intervention was associated with a better quality of life (as measured by EuroQol-visual analogue scale at 6 months 80 (70–90) vs 70 (50–80) points, p<0.001 and at 1 year 75 (70–87) vs 65 (50–80) points, p<0.001) and with a reduced perception of anxiety and/or depression (6 months: 21% vs 42%, p=0.001; 1 year 32% vs 47%, p=0.03). The occurrence of cardiac death and hospitalisation for cardiac cause was lower in the intervention group (7.5% vs 17%, p=0.04).ConclusionsThe proposed early, tailored, low-cost exercise intervention improves mobility, daily activities, quality of life and outcomes in older patients with ACS. Larger studies are needed to confirm the clinical benefit.Trial registration numberNCT03021044.

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“…First, elderly patients have a lower likelihood of undergoing PCI after ACS. In an analysis of data from the National Inpatient Sample (NIS) in the United States, Elbadawi et al reported PCI rates of 18.3% from 1998 to 2013 in patients ≥70 years of age 30 . Second, most of the ACS events in our cohort were NSTE‐ACS (88.6%), it is plausible that many of these events were deemed to be Type 2 myocardial infarctions (MI) by treating physician and were managed medically.…”

Section: Discussionmentioning

confidence: 79%

Incidence, outcomes, and predictors of in‐hospital acute coronary syndrome following endovascular transcatheter aortic valve replacement in the United States

Nazir

Ahuja

Donato

et al. 2019

Cathet Cardio Intervent

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Background Incidence and outcomes of acute coronary syndrome (ACS) immediately following transcatheter aortic valve replacement (TAVR) remain largely unknown. Objectives This study sought to assess the incidence, clinical characteristics, and outcomes of ACS following TAVR. Methods We queried the National Readmission Database from January 2012 to September 2015 for TAVR admissions with and without ACS, creating a propensity‐matched cohort to compare outcomes. Results A total of 48,454 patients underwent TAVR, with 1,332 (2.75%) developing ACS. TAVR patients with ACS compared to those without ACS had a significantly higher incidence of acute kidney injury (24.7 vs. 19.2%; p = .001), ischemic stroke (3.7 vs. 2.3%; p = .04), vascular complications (8.6 vs. 5.8%; p = .008), cardiogenic shock (9.8 vs. 1.9%; p < .001), cardiac arrest (5.1 vs. 2.8%; p = .002), mechanical circulatory support (8.1 vs. 1.5%; p < .001), and in‐hospital mortality (9.6 vs. 3.4%; p < .001). Additionally, TAVR with ACS had longer lengths of stay (median 10 days vs. 6 days; p < .001) and hospital charges (median $23,200 vs. $19,000; p < .001). Positive predictors of ACS were history of PCI (odds ratio, 1.43; 95% CI: 1.25–1.63), hyperlipidemia (odds ratio, 1.20; 95% CI: 1.07–1.34), chronic blood loss anemia (odds ratio, 2.16; 95% CI: 1.54–3.03), chronic kidney disease (odds ratio, 1.17; 95% CI: 1.04–1.31), fluid and electrolyte disorders (odds ratio, 1.65; 95% CI: 1.47–1.85), and weight loss (odds ratio, 1.53; 95% CI: 1.22–1.91). Heart failure (34%) was the most common reason for readmission in the ACS cohort. Conclusion ACS after TAVR is uncommon but is associated with worse clinical outcomes and increased healthcare resource utilization.

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National Trends and Outcomes of Percutaneous Coronary Intervention in Patients ≥70 Years of Age With Acute Coronary Syndrome (from the National Inpatient Sample Database)

Cited by 45 publications

References 21 publications

Age-Stratified Sex Disparities in Care and Outcomes in Patients With ST-Elevation Myocardial Infarction

Age-Stratified Sex Disparities in Care and Outcomes in Patients With ST-Elevation Myocardial Infarction

Exercise intervention improves quality of life in older adults after myocardial infarction: randomised clinical trial

Incidence, outcomes, and predictors of in‐hospital acute coronary syndrome following endovascular transcatheter aortic valve replacement in the United States

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