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Long-term survival in octogenarians and older patients with ST-elevation myocardial infarction in the era of primary angioplasty: A prospective cohort study
- Source :
- Eur Heart J Acute Cardiovasc Care
- Publication Year :
- 2015
- Publisher :
- Oxford University Press (OUP), 2015.
-
Abstract
- We aimed to study in-hospital mortality and long-term survival in elderly compared to younger patients with ST-segment elevation myocardial infarction (STEMI) in the era of primary angioplasty.This was a prospective cohort study. All consecutive STEMI-patients admitted to our hospital between September 2005-December 2011 were included in a local registry. Predefined variables were registered during hospital admission. Vital status was obtained from the Norwegian Cause of Death Registry with censoring date 31 December 2011. Adjusted effects of age ⩾80 years on in-hospital- and long-term mortality were determined using propensity score analysis. Of 4525 registered STEMI patients, 600 (13%) were octogenarians or older. In-hospital mortality was 17% in patients ⩾80 years and 4% in patients80 years. In invasively treated patients (83% of patients ⩾80 years; 98% of patients80 years), in-hospital mortality was 13% and 3.4%, respectively. Median follow-up time was 2.5 years. Three-year cumulative survival was 52% in patients ⩾80 years vs 89% in patients80 years. In invasively treated patients ⩾80 years, three-year survival was 58%. The adjusted odds ratio of in-hospital mortality was 2.61 (1.94-3.52) and adjusted incidence rate ratio of long-term mortality was 4.07 (3.43-4.84) in very elderly compared to younger patients.Short-term prognosis was acceptable in very elderly STEMI patients, especially in the invasively treated subgroup. However, only 52% of STEMI patients ⩾80 years were alive after three years of follow-up. Very elderly patients had 2.6 times higher risk of in-hospital mortality and 4.1 times the risk of not surviving during long-term follow-up compared to patients80 years, after adjustment for confounding factors and selection bias.
- Subjects :
- Adult
Coronary angiography
medicine.medical_specialty
medicine.medical_treatment
Primary angioplasty
030204 cardiovascular system & hematology
Critical Care and Intensive Care Medicine
03 medical and health sciences
Age Distribution
0302 clinical medicine
Older patients
St elevation myocardial infarction
Angioplasty
Internal medicine
Long term survival
Humans
Medicine
Hospital Mortality
Prospective Studies
Registries
cardiovascular diseases
030212 general & internal medicine
Myocardial infarction
Angioplasty, Balloon, Coronary
Propensity Score
Prospective cohort study
Aged
Aged, 80 and over
Norway
business.industry
Age Factors
General Medicine
Middle Aged
Prognosis
medicine.disease
Survival Analysis
Cardiology
ST Elevation Myocardial Infarction
Corrigendum
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 20488734 and 20488726
- Volume :
- 5
- Database :
- OpenAIRE
- Journal :
- European Heart Journal: Acute Cardiovascular Care
- Accession number :
- edsair.doi.dedup.....bd908d717fbb7c66e54570f669030f62