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Elderly Suffering from ST-Segment Elevation Myocardial Infarction—Results from a Database Analysis from Two Mediterranean Medical Centers

Background: Little is known regarding primary percutaneous coronary intervention (pPCI) for ST-segment elevation myocardial infarction (STEMI) in the elderly. Methods: Data on 319 octogenarians, 641 septuagenarians, and 2451 younger patients was collected from an ongoing prospective registry of pati...

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Autores principales: Perl, Leor, Franzé, Alfonso, D’Ascenzo, Fabrizio, Golomb, Noa, Levi, Amos, Vaknin-Assa, Hana, Greenberg, Gabriel, Assali, Abid, De Ferrari, Gaetano M., Kornowski, Ran
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8199382/
https://www.ncbi.nlm.nih.gov/pubmed/34070865
http://dx.doi.org/10.3390/jcm10112435
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author Perl, Leor
Franzé, Alfonso
D’Ascenzo, Fabrizio
Golomb, Noa
Levi, Amos
Vaknin-Assa, Hana
Greenberg, Gabriel
Assali, Abid
De Ferrari, Gaetano M.
Kornowski, Ran
author_facet Perl, Leor
Franzé, Alfonso
D’Ascenzo, Fabrizio
Golomb, Noa
Levi, Amos
Vaknin-Assa, Hana
Greenberg, Gabriel
Assali, Abid
De Ferrari, Gaetano M.
Kornowski, Ran
author_sort Perl, Leor
collection PubMed
description Background: Little is known regarding primary percutaneous coronary intervention (pPCI) for ST-segment elevation myocardial infarction (STEMI) in the elderly. Methods: Data on 319 octogenarians, 641 septuagenarians, and 2451 younger patients was collected from an ongoing prospective registry of patients treated with pPCI for STEMI at two Mediterranean-area medical centers in 2009–2017. Results: More octogenarian patients were female (40.8 vs. 31.9 septuagenarians and 26.5% under 70 y, p < 0.01), had hypertension (79.5 vs. 69.5 and 45.9%, p < 0.01), renal failure (32.5 vs. 20.1 and 5.2%, p < 0.01), and a lower left-ventricular ejection fraction (42.0 vs. 44.9 and 47.6%, p = 0.012). At 1 month and 3 years after intervention, mortality was higher in the octogenarian patients (12.2 vs. 7.9%, p = 0.01; and 36.7 vs. 23.1%, p < 0.01, respectively), with no significant differences in the rates of recurrent myocardial infarction, target vessel revascularization, coronary artery bypass surgery, and cardiovascular death. Following adjustment for confounders, 3-year mortality was significantly higher in the octogenarians (HR 3.89 vs. 3.19 for septuagenarians, p < 0.01), but rates of major adverse cardiac events or cardiovascular death were not. Conclusions: Despite suffering from higher all-cause mortality, octogenarian patients treated with pPCI for STEMI do not suffer an increased risk of ischemic cardiac events relative to younger patients.
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spelling pubmed-81993822021-06-14 Elderly Suffering from ST-Segment Elevation Myocardial Infarction—Results from a Database Analysis from Two Mediterranean Medical Centers Perl, Leor Franzé, Alfonso D’Ascenzo, Fabrizio Golomb, Noa Levi, Amos Vaknin-Assa, Hana Greenberg, Gabriel Assali, Abid De Ferrari, Gaetano M. Kornowski, Ran J Clin Med Article Background: Little is known regarding primary percutaneous coronary intervention (pPCI) for ST-segment elevation myocardial infarction (STEMI) in the elderly. Methods: Data on 319 octogenarians, 641 septuagenarians, and 2451 younger patients was collected from an ongoing prospective registry of patients treated with pPCI for STEMI at two Mediterranean-area medical centers in 2009–2017. Results: More octogenarian patients were female (40.8 vs. 31.9 septuagenarians and 26.5% under 70 y, p < 0.01), had hypertension (79.5 vs. 69.5 and 45.9%, p < 0.01), renal failure (32.5 vs. 20.1 and 5.2%, p < 0.01), and a lower left-ventricular ejection fraction (42.0 vs. 44.9 and 47.6%, p = 0.012). At 1 month and 3 years after intervention, mortality was higher in the octogenarian patients (12.2 vs. 7.9%, p = 0.01; and 36.7 vs. 23.1%, p < 0.01, respectively), with no significant differences in the rates of recurrent myocardial infarction, target vessel revascularization, coronary artery bypass surgery, and cardiovascular death. Following adjustment for confounders, 3-year mortality was significantly higher in the octogenarians (HR 3.89 vs. 3.19 for septuagenarians, p < 0.01), but rates of major adverse cardiac events or cardiovascular death were not. Conclusions: Despite suffering from higher all-cause mortality, octogenarian patients treated with pPCI for STEMI do not suffer an increased risk of ischemic cardiac events relative to younger patients. MDPI 2021-05-30 /pmc/articles/PMC8199382/ /pubmed/34070865 http://dx.doi.org/10.3390/jcm10112435 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Perl, Leor
Franzé, Alfonso
D’Ascenzo, Fabrizio
Golomb, Noa
Levi, Amos
Vaknin-Assa, Hana
Greenberg, Gabriel
Assali, Abid
De Ferrari, Gaetano M.
Kornowski, Ran
Elderly Suffering from ST-Segment Elevation Myocardial Infarction—Results from a Database Analysis from Two Mediterranean Medical Centers
title Elderly Suffering from ST-Segment Elevation Myocardial Infarction—Results from a Database Analysis from Two Mediterranean Medical Centers
title_full Elderly Suffering from ST-Segment Elevation Myocardial Infarction—Results from a Database Analysis from Two Mediterranean Medical Centers
title_fullStr Elderly Suffering from ST-Segment Elevation Myocardial Infarction—Results from a Database Analysis from Two Mediterranean Medical Centers
title_full_unstemmed Elderly Suffering from ST-Segment Elevation Myocardial Infarction—Results from a Database Analysis from Two Mediterranean Medical Centers
title_short Elderly Suffering from ST-Segment Elevation Myocardial Infarction—Results from a Database Analysis from Two Mediterranean Medical Centers
title_sort elderly suffering from st-segment elevation myocardial infarction—results from a database analysis from two mediterranean medical centers
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8199382/
https://www.ncbi.nlm.nih.gov/pubmed/34070865
http://dx.doi.org/10.3390/jcm10112435
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