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Outcomes of Elderly Patients with ST-Elevation or Non-ST-Elevation Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention.
- Source :
-
American Journal of Medicine . Feb2019, Vol. 132 Issue 2, p209-216. 8p. - Publication Year :
- 2019
-
Abstract
- <bold>Introduction: </bold>Acute coronary syndromes (ACS) have been classified according to the finding of ST-segment elevation on the presenting electrocardiogram, with different treatment strategies and practice guidelines. However, a comparative description of the clinical characteristics and outcomes of acute coronary syndrome elderly patients undergoing percutaneous coronary intervention during index admission has not been published so far.<bold>Methods: </bold>Retrospective cohort study of patients enrolled in the Elderly ACS-2 multicenter randomized trial. Main outcome measures were crude cumulative incidence and cause-specific hazard ratio (cHR) of cardiovascular death, noncardiovascular death, reinfarction, and stroke.<bold>Results: </bold>Of 1443 ACS patients aged >75 years (median age 80 years, interquartile range 77-84), 41% were classified as ST-elevation myocardial infarction (STEMI), and 59% had non-ST-elevation ACS (NSTEACS) (48% NSTEMI and 11% unstable angina). As compared with those with NSTEACS, STEMI patients had more favorable baseline risk factors, fewer prior cardiovascular events, and less severe coronary disease, but lower ejection fraction (45% vs 50%, P < .001). At a median follow-up of 12 months, 51 (8.6%) STEMI patients had died, vs 39 (4.6%) NSTEACS patients. After adjusting for sex, age, and previous myocardial infarction, the hazard among the STEMI group was significantly higher for cardiovascular death (cHR 1.85; 95% confidence interval [CI], 1.02-3.36), noncardiovascular death (cHR 2.10; 95% CI, 1.01-4.38), and stroke (cHR 4.8; 95% CI, 1.7-13.7).<bold>Conclusions: </bold>Despite more favorable baseline characteristics, elderly STEMI patients have worse survival and a higher risk of stroke compared with NSTEACS patients after percutaneous coronary intervention. [ABSTRACT FROM AUTHOR]
- Subjects :
- *STROKE
*PERCUTANEOUS coronary intervention
*ACUTE coronary syndrome
*MYOCARDIAL infarction
*OLDER patients
*MYOCARDIAL infarction treatment
*TREATMENT of acute coronary syndrome
*CARDIOVASCULAR system
*ELECTROCARDIOGRAPHY
*LONGITUDINAL method
*MEDICAL care
*TREATMENT effectiveness
*RETROSPECTIVE studies
Subjects
Details
- Language :
- English
- ISSN :
- 00029343
- Volume :
- 132
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- American Journal of Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 134274794
- Full Text :
- https://doi.org/10.1016/j.amjmed.2018.10.027