Outcome of Percutaneous Coronary Intervention in Old Patients Presenting with Acute Coronary Syndrome

被引:2
作者
Fallahzadeh, Aida [1 ,2 ]
Sheikhy, Ali [1 ,2 ]
Aein, Afsaneh [3 ]
Salarifar, Mojtaba [4 ]
Pourhosseini, Hamidreza [4 ]
Aghajani, Hassan [4 ]
Alidoosti, Mohammad [4 ]
Sadeghian, Saeed [4 ]
Hosseini, Kaveh [4 ]
机构
[1] Univ Tehran Med Sci, Tehran Heart Ctr, Tehran, Iran
[2] Univ Tehran Med Sci, Endocrinol & Metab Populat Sci Inst, Noncommunicable Dis Res Ctr, Tehran, Iran
[3] Iran Univ Med Sci, Sch Publ Hlth, Dept Hlth Educ & Hlth Promot, Tehran, Iran
[4] Univ Tehran Med Sci, Dept Cardiol, Tehran Heart Ctr, Tehran, Iran
关键词
Elderly; Major adverse cardiac events; Octogenarian; Percutaneous coronary intervention; ELEVATION MYOCARDIAL-INFARCTION; PREDICTORS; MORTALITY; AGE; COMPLICATIONS; OCTOGENARIANS; ANGIOPLASTY; CHOLESTEROL; STATEMENT; SOCIETY;
D O I
10.34172/aim.2022.84
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Octogenarians (age >= 80 years) with coronary artery disease constitute a high-risk group and the elderly undergoing percutaneous coronary intervention (PCI) are at higher risk of adverse outcomes compared to young patients. In this study, we aimed to describe the outcomes of the elderly with acute coronary syndrome (ACS) who underwent PCI and also to identify the predictors of short-term major adverse cerebrocardiovascular events (MACCE) in octogenarians. Methods: In this registry-based cohort study, we reviewed the data of patients (aged >= 65 years) who underwent PCI. Univariate Cox-regression model was used to assess the univariate effects of covariates on mortality and MACCE and multivariate Cox -regression analysis were used to discover MACCE predictors. Results: We reviewed the data of 3332 patients (2722 elderly [65 to 79 years], and 610 octogenarians [ >= 80 years]). The cumulative hazard of MACCE was significantly higher in the octogenarian group compared with the younger group (P < 0.001). MACCE in octogenarians presenting with ST-elevation myocardial infarction (STEMI) was significantly higher than those with non-ST -elevation myocardial infarction/Unstable angina (NSTEMI/UA) (P < 0.001); however, the cumulative hazard of mortality was not significantly different between the two groups (P = 0.270). Successful PCI, left main stenosis and estimated glomerular filtration rate (eGFR) were independent predictors of MACCE in octogenarians with ACS. Conclusion: Octogenarians undergoing PCI had a higher rate of MACCE and mortality compared with a younger population. In octogenarians, MACCE in those with STEMI was significantly higher than those with NSTEMI/UA and the mortality trend was similar; however, the 1-year trend was in favor of the STEMI subgroup.
引用
收藏
页码:523 / 532
页数:10
相关论文
共 40 条
[1]   Trends in cardiogenic shock complicating acute myocardial infarction [J].
Aissaoui, Nadia ;
Puymirat, Etienne ;
Delmas, Clement ;
Ortuno, Sofia ;
Durand, Eric ;
Bataille, Vincent ;
Drouet, Elodie ;
Bonello, Laurent ;
Bonnefoy-Cudraz, Eric ;
Lesmeles, Gilles ;
Guerot, Emmanuel ;
Schiele, Francois ;
Simon, Tabassome ;
Danchin, Nicolas .
EUROPEAN JOURNAL OF HEART FAILURE, 2020, 22 (04) :664-672
[2]   Acute coronary care in the elderly, Part II - ST-segment-elevation myocardial infarction - A scientific statement for healthcare professionals from the American Heart Association council on clinical cardiology - In collaboration with the Society of Geriatric Cardiology [J].
Alexander, Karen P. ;
Newby, L. Kristin ;
Armstrong, Paul W. ;
Cannon, Christopher P. ;
Gibler, W. Brian ;
Rich, Michael W. ;
Van de Werf, Frans ;
White, Harvey D. ;
Weaver, W. Douglas ;
Naylor, Mary D. ;
Gore, Joel M. ;
Krumholz, Harlan M. ;
Ohman, E. Magnus .
CIRCULATION, 2007, 115 (19) :2570-2589
[3]  
Amer Diabet Assoc, 2010, DIABETES CARE, V33, pS11, DOI [10.2337/dc10-S062, 10.2337/dc11-S011, 10.2337/dc10-S011, 10.2337/dc14-S081, 10.2337/dc13-S067, 10.2337/dc12-s064, 10.2337/dc11-S062, 10.2337/dc13-S011, 10.2337/dc12-s011]
[4]   Outcomes after primary percutaneous coronary intervention in octogenarians and nonagenarians with ST-segment elevation myocardial infarction: From the Western Denmark heart registry [J].
Antonsen, Lisbeth ;
Jensen, Lisette Okkels ;
Terkelsen, Christian Juhl ;
Tilsted, Hans-Henrik ;
Junker, Anders ;
Maeng, Michael ;
Hansen, Knud Noerregaard ;
Lassen, Jens Flensted ;
Thuesen, Leif ;
Thayssen, Per .
CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2013, 81 (06) :912-919
[5]   The dilemma of success:: Percutaneous coronary interventions in patients ≥ 75 years of age -: Successful but associated with higher vascular complications and cardiac mortality [J].
Assali, AR ;
Moustapha, A ;
Sdringola, S ;
Salloum, J ;
Awadalla, H ;
Saikia, S ;
Ghani, M ;
Hale, S ;
Schroth, G ;
Rosales, O ;
Anderson, HV ;
Smalling, RW .
CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2003, 59 (02) :195-199
[6]   Contemporary outcome trends in the elderly undergoing percutaneous coronary interventions: Results in 7,472 octogenarians [J].
Batchelor, WB ;
Anstrom, KJ ;
Muhlbaier, LH ;
Grosswald, R ;
Weintraub, WS ;
O'Neill, WW ;
Peterson, ED .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2000, 36 (03) :723-730
[7]  
Bauer T., 2010, Interv Cardiol, V2, P319, DOI [10.2217/ica.10.27, DOI 10.2217/ICA.10.27]
[8]   Predictors of hospital mortality in the elderly undergoing percutaneous coronary intervention for acute coronary syndromes and stable angina [J].
Bauer, Timm ;
Moellmann, Helge ;
Weidinger, Franz ;
Zeymer, Uwe ;
Seabra-Gomes, Ricardo ;
Eberli, Franz ;
Serruys, Patrick ;
Vahanian, Alec ;
Silber, Sigmund ;
Wijns, William ;
Hochadel, Matthias ;
Nef, Holger M. ;
Hamm, Christian W. ;
Marco, Jean ;
Gitt, Anselm K. .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2011, 151 (02) :164-169
[9]   Comparison of Short- and Long-Term Prognosis between ST-Elevation and Non-ST-Elevation Myocardial Infarction [J].
Bouisset, Frederic ;
Ruidavets, Jean-Bernard ;
Dallongeville, Jean ;
Moitry, Marie ;
Montaye, Michele ;
Biasch, Katia ;
Ferrieres, Jean .
JOURNAL OF CLINICAL MEDICINE, 2021, 10 (02) :1-10
[10]   Impact of treatment delays on outcomes of primary percutaneous coronary intervention for acute myocardial infarction: Analysis from the CADILLAC trial [J].
Brodie, BR ;
Stone, GW ;
Cox, DA ;
Stuckey, TD ;
Turco, M ;
Tcheng, JE ;
Berger, P ;
Mehran, R ;
McLaughlin, M ;
Costantini, C ;
Lansky, AJ ;
Grines, CL .
AMERICAN HEART JOURNAL, 2006, 151 (06) :1231-1238