Invasive versus Conservative Treatment Approach among Older Adult Patients Admitted with Acute ST-Segment Elevation Myocardial Infarction.
Alder adults
Conservative treatment
Invasive treatment
ST elevation myocardial infarction
STEMI
Journal
Annals of geriatric medicine and research
ISSN: 2508-4909
Titre abrégé: Ann Geriatr Med Res
Pays: Korea (South)
ID NLM: 101701105
Informations de publication
Date de publication:
Dec 2022
Dec 2022
Historique:
received:
16
07
2022
accepted:
22
11
2022
pubmed:
29
11
2022
medline:
29
11
2022
entrez:
28
11
2022
Statut:
ppublish
Résumé
Primary percutaneous coronary intervention (PCI) is the preferred treatment strategy for patients with ST-elevation myocardial infarction (STEMI); however, its efficacy remains unclear in very older adult patients with STEMI. This retrospective single-center observational study included 530 patients aged >75 years admitted to Tel Aviv Sourasky Medical Center with a diagnosis of acute STEMI. Primary PCI was performed for patients with symptoms ≤12 hours in duration, while the other patients were conservatively treated. We evaluated 30-day mortality and complications occurring during hospitalization based on data from patient records. Among the study patients, only 28/530 (5%) were conservatively treated. In-hospital complications, including the use of inotropes or intra-aortic balloon counterpulsation and the need for mechanical ventilation, did not differ significantly between the groups. The only parameter that showed a trend toward significance was the incidence of heart failure during hospitalization (p=0.042). The risk for 30-day mortality was substantially higher in the conservative treatment group than in the invasive treatment group (27% vs. 10%; p = 0.02). Our data suggested that despite concerns regarding the safety of the primary PCI strategy in the older adult STEMI population, this treatment strategy was associated with a survival benefit.
Sections du résumé
BACKGROUND
BACKGROUND
Primary percutaneous coronary intervention (PCI) is the preferred treatment strategy for patients with ST-elevation myocardial infarction (STEMI); however, its efficacy remains unclear in very older adult patients with STEMI.
METHODS
METHODS
This retrospective single-center observational study included 530 patients aged >75 years admitted to Tel Aviv Sourasky Medical Center with a diagnosis of acute STEMI. Primary PCI was performed for patients with symptoms ≤12 hours in duration, while the other patients were conservatively treated. We evaluated 30-day mortality and complications occurring during hospitalization based on data from patient records.
RESULTS
RESULTS
Among the study patients, only 28/530 (5%) were conservatively treated. In-hospital complications, including the use of inotropes or intra-aortic balloon counterpulsation and the need for mechanical ventilation, did not differ significantly between the groups. The only parameter that showed a trend toward significance was the incidence of heart failure during hospitalization (p=0.042). The risk for 30-day mortality was substantially higher in the conservative treatment group than in the invasive treatment group (27% vs. 10%; p = 0.02).
CONCLUSION
CONCLUSIONS
Our data suggested that despite concerns regarding the safety of the primary PCI strategy in the older adult STEMI population, this treatment strategy was associated with a survival benefit.
Identifiants
pubmed: 36437630
pii: agmr.22.0079
doi: 10.4235/agmr.22.0079
pmc: PMC9830063
doi:
Types de publication
Journal Article
Langues
eng
Pagination
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