The impact of periprocedural myocardial infarction on mortality in older adults with non-ST-segment elevation acute coronary syndrome: a pooled analysis of the FRASER and HULK studies.
Aged
Exercise Therapy
/ methods
Female
Frailty
/ diagnosis
Hand Strength
Health Education
/ methods
Heart Disease Risk Factors
Humans
Italy
/ epidemiology
Male
Mortality
Non-ST Elevated Myocardial Infarction
/ diagnosis
Outcome and Process Assessment, Health Care
Percutaneous Coronary Intervention
/ adverse effects
Perioperative Care
/ methods
Physical Functional Performance
Prognosis
Journal
Journal of cardiovascular medicine (Hagerstown, Md.)
ISSN: 1558-2035
Titre abrégé: J Cardiovasc Med (Hagerstown)
Pays: United States
ID NLM: 101259752
Informations de publication
Date de publication:
01 07 2021
01 07 2021
Historique:
entrez:
2
6
2021
pubmed:
3
6
2021
medline:
25
12
2021
Statut:
ppublish
Résumé
The prognostic implication of periprocedural myocardial infarction (MI) in older patients has been less investigated. The aim of this study is to assess the relationship between large periprocedural MI and long-term mortality in older patients with non-ST-segment elevation acute coronary syndrome (NSTEACS) undergoing percutaneous coronary intervention (PCI). This is a pooled analysis of older NSTEACS patients who were included in the FRASER and HULK studies. Periprocedural MI was defined in agreement with the Society for Cardiovascular Angiography and Interventions definition. The primary outcome was all-cause mortality. The secondary outcome was cardiovascular mortality. The predictors of periprocedural MI and the relationship with scales of physical performance, namely Short Physical Performance Battery and grip strength, were also investigated. The study included 586 patients. Overall, periprocedural MI occurred in 24 (4.1%) patients. After a median follow-up of 1023 (740-1446) days, the primary endpoint occurred in 94 (16%) patients. After multivariable analysis, periprocedural MI emerged as an independent predictor of all-cause mortality (hazard risk 4.30, 95% confidence interval 2.27-8.12). This finding was consistent for cardiovascular mortality (hazard risk 7.45, 95% confidence interval 3.56-15.67). SYNTAX score, multivessel PCI and total stent length were independent predictors of large periprocedural MI. At hospital discharge, patients suffering from periprocedural MI showed poor values of Short Physical Performance Battery and grip strength as compared with others. In a cohort of older NSTEACS patients undergoing PCI, large periprocedural MI occurred in around 4% of patients and was associated with long-term occurrence of all-cause and cardiovascular mortality. ClinicalTrials.gov: NCT02324660 and NCT03021044.
Identifiants
pubmed: 34076602
doi: 10.2459/JCM.0000000000001146
pii: 01244665-202107000-00004
doi:
Banques de données
ClinicalTrials.gov
['NCT03021044', 'NCT02324660']
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
546-552Informations de copyright
Copyright © 2021 Italian Federation of Cardiology - I.F.C. All rights reserved.
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