Safety, Effectiveness, and Outcomes of Cardiac Catheterization in Nonagenarians

LeBude, Bryan; Fischman, David L.; Savage, Michael P.; Jasti, Babu; Ogilby, David; McCarey, Melissa; Adams, Suzanne; Vallabhan, T.; Walinsky, Paul

doi:10.1016/j.amjcard.2012.06.019

Cited by 7 publications

(6 citation statements)

References 13 publications

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“…Cardiac events and ACS were other major causes for admission in 14.2%. Receiving full management with catheterization, stenting, 23 and cardiac surgery 24,25 is considered debatable for older individuals, even among members of the medical field who commonly treat nonagenarians.…”

Section: Discussionmentioning

confidence: 99%

Acute kidney injury among nonagenarians in Jordan: a retrospective case–control study

Alshelleh

Oweis

Alzoubi

2018

IJNRD

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BackgroundImprovements in health care systems worldwide have had notable effects on the life expectancy of older individuals. As a result, nonagenarians are emerging as a separate age group with distinct health care needs. The aim of this study was to evaluate the incidence of acute kidney injury (AKI), the mortality rates, and length of in-hospital stay among nonagenarians.MethodsThis is a retrospective case–control chart review of patients of age 90 years and above who were admitted to hospital. Patients with Stage I, II, or III chronic kidney disease were included in the analysis. The incidence of AKI was determined using data from the Acute Kidney Injury Network (AKIN) classification. Primary outcome variables included length of in-hospital stay and mortality rates.ResultsOf the 253 patients who were included in the study, the mean age was 91.5 years, 61 of the patients (25.9%) developed AKI, and 41 patients (66.1%) were in Stage I AKI according to AKIN criteria. Fifty-seven patients died during the study period; 57.9% of those patients had AKI. Hospital stay was longer in patients with AKI with a mean length of stay of 8.1 days. Congestive heart failure, cancer, and use of non-steroidal anti-inflammatory drugs were the main risk factors for AKI among those patients.ConclusionAKI is common in nonagenarians. It was associated with increased length of hospital stays and increased risk for mortality.

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Section: Discussionmentioning

confidence: 99%

Acute kidney injury among nonagenarians in Jordan: a retrospective case–control study

Alshelleh

Oweis

Alzoubi

2018

IJNRD

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“…Cardiovascular disease and more particularly ischaemic heart disease among nonagenarians is the most studied disease in the literature. In the article of Biondi Zoccai G et al [13], a review of 18 articles (1082 patients) on the subject of effectiveness and tolerance of percutaneous coronary intervention (PCI) was detailed [32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49]. Among these studies, there was a great variability in patient selection, as well as features and results.…”

Section: Medical Treatment Of Nonagenarian Patientsmentioning

confidence: 99%

General management of nonagenarian patients: a review of the literature

Rivoirard¹,

Chargari²,

Trone³

et al. 2014

Swiss Med Wkly

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The number of nonagenarian people in the world is steadily growing. This phenomenon will increase in future years: in 2050, world population prospects estimate 71.16 million people aged 90 years or older. The two main causes of death among people aged 85 years or more in Europe in 2003 were cardiovascular and cerebrovascular diseases and cancers. However, the elderly are often excluded from clinical trials; they are underrepresented in clinical registries and especially nonagenarians. Care (medical, surgical, oncology) of these very elderly is currently insufficiently based on scientific recommendations. For the physician, the choice to treat or not to treat very elderly patients (for fear of side effects) is difficult. Oncology is particularly affected by this problem. Here we review these different fields of internal medicine management of nonagenarian patients with a special focus on oncology and on comprehensive geriatric assessment as a base for all care decision taking.

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“…Nonagenarians are a subgroup of patients even more peculiar than their younger counterpart (Table 2, Ref. [55][56][57][58]). Rigattieri et al [55] reported a higher prevalence of the female gender, and a low percentage of common risk factors, which may result from a selection bias as these characteristics allow the population to achieve such an advanced age.…”

Section: Focus On Nonagenarian Patientsmentioning

confidence: 99%

“…This population is particularly underrepre-sented in RCTs. The available evidence comes from a few small observational trials [56][57][58]. In nonagenarians, mortality appears to be significantly higher when angioplasty is performed in the setting of unstable CAD.…”

Section: Focus On Nonagenarian Patientsmentioning

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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Safety, Effectiveness, and Outcomes of Cardiac Catheterization in Nonagenarians

Cited by 7 publications

References 13 publications

Acute kidney injury among nonagenarians in Jordan: a retrospective case–control study

Acute kidney injury among nonagenarians in Jordan: a retrospective case–control study

General management of nonagenarian patients: a review of the literature

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

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Safety, Effectiveness, and Outcomes of Cardiac Catheterization in Nonagenarians

Cited by 7 publications

References 13 publications

Acute kidney injury among nonagenarians in Jordan: a retrospective case&ndash;control study

Acute kidney injury among nonagenarians in Jordan: a retrospective case&ndash;control study

General management of nonagenarian patients: a review of the literature

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

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Acute kidney injury among nonagenarians in Jordan: a retrospective case–control study

Acute kidney injury among nonagenarians in Jordan: a retrospective case–control study