Are the elderly different? Factors influencing mortality after percutaneous coronary intervention with stent implantation

被引:0
|
作者
Schroeder, J. [1 ]
Mueller-Werdan, U. [1 ]
Reuter, S. [2 ]
Vogt, A. [1 ]
Schlitt, M. [1 ]
Raaz, U. [1 ]
Reindl, I. [1 ]
Buerke, M. [1 ]
Werdan, K. [1 ]
Schlitt, A. [1 ]
机构
[1] Univ Klinikum Halle Saale, Univ Klin & Poliklin Innere Med 3, D-06120 Halle, Germany
[2] Diakoniekrankenhaus Halle, Klin Geriatrie, Halle, Germany
来源
ZEITSCHRIFT FUR GERONTOLOGIE UND GERIATRIE | 2013年 / 46卷 / 02期
关键词
Elderly; Coronary heart disease; Stent implantation; Risk factor; Mortality; CARDIOVASCULAR RISK; HEART-DISEASE; FAILURE; EVENTS; OLDER;
D O I
10.1007/s00391-012-0338-y
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
The aim of this study was to investigate factors influencing mortality after percutaneous coronary intervention (PCI) in patients aged a parts per thousand yenaEuro parts per thousand 75 years compared to younger patients. A total of 1,809 coronary heart disease (CHD) patients after PCI with stent implantation in our hospital were assessed. Kaplan-Meier analyses with log-rank test and Cox regression analyses were performed on three predefined models concerning primary endpoint of all-cause mortality. Model 1 was a univariate analysis of the influence of age dichotomized by age 75 years on the primary endpoint. Model 2 included age and classical cardiovascular risk factors (CVRFs, e.g., body mass index (BMI), smoking, diabetes, and hypertension). Model 3 consisted of age, classical CVRFs, and additional factors (e.g., medication; hemoglobin, peripheral arterial disease (PAD), low-density lipoprotein cholesterol (LDL-C) and creatinine levels, and left ventricular ejection fraction (LVEF)). In the mean follow-up of 137 +/- 61 weeks 375 patients died. Age a parts per thousand yenaEuro parts per thousand 75 years was significantly related to mortality in all models. In model 3, previous stroke, PAD, diabetes, elevated levels of serum creatinine, and increased LDL-C were related to elevated mortality, higher hemoglobin levels, and LVEF > 50% were associated with decreased mortality in all patients and in patients < 75 years. In patients a parts per thousand yenaEuro parts per thousand 75 years arterial hypertension was associated with poor outcome (hazard ratio (HR) 7.989, p = 0.040), previous antiplatelet therapy showed reduced mortality (HR 0.098, p = 0.039). Although risk factors such as previous stroke, PAD, diabetes, renal insufficiency, and anemia were predictors for death in all patients and patients < 75 years, in the elderly only arterial hypertension increased, whereas treatment with platelet inhibitors decreased mortality.
引用
收藏
页码:144 / 150
页数:7
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