Primary angioplasty for acute myocardial infarction in octogenarians

Matetzky, Shlomi; Sharir, Tali; Noč, Marko; Domingo, Michelle; Chyu, Kuang‐Yuh; Kar, Saibal; Eigler, Neal; Kaul, Sanjay; Shah, Prediman K.; Cercek, Bojan

doi:10.1016/s0002-9149(01)01816-1

Cited by 10 publications

(3 citation statements)

References 18 publications

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“…PTCA was performed in 5 (4.67%) elderly patients and 16 (17.2%) younger ones, 32,33 proved that elderly patients benefit from reperfusion therapy, they received both thrombolytic and invasive procedures less frequently when compared with younger patients. 30,31 This paradox phenomenon was observed in many clinical studies and registries, 33 and was confirmed in our study well. The elderly AMI patients were as likely to receive anti-platelet agents and ACE inhibitors.…”

Section: Discussionsupporting

confidence: 90%

“…In aging persons, the atrio-ventricular conduction system is subject to spontaneous fibrosis and more vulnerable to ischemia and necrosis. 29 Despite the fact that older patients constitute the group of high coronary risk and that numerous observations and studies proved that these patients benefit significantly from PCI in acute MI, 30,31 invasive procedures in this group of patients are performed relatively rarely. This was consistent with our observations.…”

Section: Discussionmentioning

confidence: 99%

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Clinical profile of acute myocardial infarction in elderly patients

Bhatia

Naik

2013

Journal of Cardiovascular Disease Research

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a b s t r a c tContext: The aim of study was to determine the difference in presentation, risk factors, complications, management and outcome of elderly and young patients with acute myocardial infarction (AMI). Settings and design: Tertiary care center; prospective observational study. Materials and method: The study included 200 consecutive patients with AMI admitted in the ICCU, in a tertiary care center in West India. The group I consisted of 107 patients aged equal to or above 65 years and the group II consisted of 93 patients aged below 65 years. Statistical analysis: Two tailed student's t test and Chi-square statistics (Fisher's test) for P value. Results: The male female ratio was 1.27:1 and 3.43:1 in group I and group II respectively. Atypical presentations were more likely in the elderly, with shortness of breath as the most common presentation (40.18% versus 15.05%; P < 0.05. Risk factors like hypertension, dyslipidemia and diabetes were equally present in both groups but obesity, smoking and family history of coronary artery disease was more prevalent in younger age group (P < 0.05). The elderly were significantly less frequently revascularized (P < 0.05). Time from symptom onset to hospital admission was significantly longer in the case of elderly patients (P < 0.05). The elderly were more likely to have complications of cardiac failure (P < 0.05) and arrhythmias especially atrio-ventricular (AV) blocks. The elderly were also less likely to receive betablockers (P < 0.05). In-hospital mortality was higher in the elderly (P < 0.001). Conclusion: We conclude that the manifestations of AMI are more subtle in the elderly, with different risk factors.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Clinical profile of acute myocardial infarction in elderly patients

Bhatia

Naik

2013

Journal of Cardiovascular Disease Research

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“…5,9,10 Most studies have reported that older age is associated with decreased procedural success and/ or increased in-hospital complications. 8,[10][11][12][13][14][15][16][17][18] In the elderly, coronary disease is diffuse and the vessels are more often severely calcified. Therefore, the procedure is often technically difficult.…”

mentioning

confidence: 99%

Procedural and long-term outcome of primary percutaneous coronary intervention in octogenarians

Moonen

Veer²,

Pijls³

2010

NHJL

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Background/objectives. To investigate the procedural and long-term outcome of primary percutaneous coronary intervention (PCI) in octogenarians with an acute myocardial infarction.Methods. We performed a retrospective analysis of all consecutive octogenarian patients (n=98) with an acute myocardial infarction treated with primary PCI in the Catharina Hospital in the year 2006. We compared procedural results and outcome with a matched control group composed of non-octogenarians undergoing primary PCI. Follow-up period was one year.Results. The initial success rate of PCI was similar in the two groups but short-term mortality was higher among the elderly patients: 30-day mortality 26.3 vs. 9.6%. Age-adjusted mortality between 30 days and one year was comparable in the two groups and similar to natural survival in the Netherlands. Octogenarians were less likely to have a normal left ventricular function during follow-up (48.3 vs. 66.7%). New York Heart Association (NYHA) class and recurrence rate of myocardial infarction was higher among octogenarians.Conclusion. Technical success rate during primary PCI was as good for octogenarians as in younger patients, but 30-day mortality, though acceptable, was higher among the elderly. After 30 days, age-adjusted mortality was comparable in both groups. (Neth Heart J 2010;18:129-34.).

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