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Prognosis Between ST-Elevation and Non-ST-elevation Myocardial Infarction in Older Adult Patients
Background: Whether there is a difference in prognosis between elderly patients with ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) remains mysterious. Methods: We conducted a retrospective cohort study by analyzing the data in the Longitudinal Health...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8761910/ https://www.ncbi.nlm.nih.gov/pubmed/35047571 http://dx.doi.org/10.3389/fcvm.2021.749072 |
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author | Chang, Shih-Sheng Lu, Chiung-Ray Chen, Ke-Wei Kuo, Zhe-Wei Yu, Shao-Hua Lin, Shih-Yi Shi, Hong-Mo Yip, Hei-Tung Kao, Chia-Hung |
author_facet | Chang, Shih-Sheng Lu, Chiung-Ray Chen, Ke-Wei Kuo, Zhe-Wei Yu, Shao-Hua Lin, Shih-Yi Shi, Hong-Mo Yip, Hei-Tung Kao, Chia-Hung |
author_sort | Chang, Shih-Sheng |
collection | PubMed |
description | Background: Whether there is a difference in prognosis between elderly patients with ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) remains mysterious. Methods: We conducted a retrospective cohort study by analyzing the data in the Longitudinal Health Insurance Database (LHID) in Taiwan to explore differences between STEMI and NSTEMI with respect to in-hospital and long-term (3-year) outcomes among older adult patients (aged ≥65 years). Patients were further stratified based on whether they received coronary revascularization. Results: In total, 5,902 patients aged ≥65 years with acute myocardial infarction (AMI) who underwent revascularization (2,254) or medical therapy alone (3,648) were included. In the revascularized group, no difference was observed in cardiovascular (CV) and all-cause mortality during hospitalization or at 3-year follow-up between the two AMIs. Conversely, in the non-revascularized group, patients with NSTEMI had higher crude odds ratio (cOR) for all-cause death during hospitalization [cOR: 1.33, 95% confidence interval (CI) = 1.07–1.65] and at 3-year follow-up (cOR: 1.47, 95% CI = 1.21–1.91) relative to patients with STEMI. However, after multivariable adjustments, only NSTEMI indicated fewer in-hospital CV death [adjusted odds ratio (aOR): 0.75, 95% CI = 0.58–0.98] than STEMI in non-revascularized group. Moreover, major bleeding was not different between patients with STEMI or NSTEMI aged ≥65 years old. Conclusion: Classification of AMI is not associated with the difference of in-hospital or 3-year CV and all-cause death in older adult patients received revascularization. In a 3-year follow-up period, STEMI was an independent predictor of a higher incidence of revascularization after the index event. Non-ST-elevation myocardial infarction had more incidence of MACE than patients with STEMI did in both treatment groups. |
format | Online Article Text |
id | pubmed-8761910 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-87619102022-01-18 Prognosis Between ST-Elevation and Non-ST-elevation Myocardial Infarction in Older Adult Patients Chang, Shih-Sheng Lu, Chiung-Ray Chen, Ke-Wei Kuo, Zhe-Wei Yu, Shao-Hua Lin, Shih-Yi Shi, Hong-Mo Yip, Hei-Tung Kao, Chia-Hung Front Cardiovasc Med Cardiovascular Medicine Background: Whether there is a difference in prognosis between elderly patients with ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) remains mysterious. Methods: We conducted a retrospective cohort study by analyzing the data in the Longitudinal Health Insurance Database (LHID) in Taiwan to explore differences between STEMI and NSTEMI with respect to in-hospital and long-term (3-year) outcomes among older adult patients (aged ≥65 years). Patients were further stratified based on whether they received coronary revascularization. Results: In total, 5,902 patients aged ≥65 years with acute myocardial infarction (AMI) who underwent revascularization (2,254) or medical therapy alone (3,648) were included. In the revascularized group, no difference was observed in cardiovascular (CV) and all-cause mortality during hospitalization or at 3-year follow-up between the two AMIs. Conversely, in the non-revascularized group, patients with NSTEMI had higher crude odds ratio (cOR) for all-cause death during hospitalization [cOR: 1.33, 95% confidence interval (CI) = 1.07–1.65] and at 3-year follow-up (cOR: 1.47, 95% CI = 1.21–1.91) relative to patients with STEMI. However, after multivariable adjustments, only NSTEMI indicated fewer in-hospital CV death [adjusted odds ratio (aOR): 0.75, 95% CI = 0.58–0.98] than STEMI in non-revascularized group. Moreover, major bleeding was not different between patients with STEMI or NSTEMI aged ≥65 years old. Conclusion: Classification of AMI is not associated with the difference of in-hospital or 3-year CV and all-cause death in older adult patients received revascularization. In a 3-year follow-up period, STEMI was an independent predictor of a higher incidence of revascularization after the index event. Non-ST-elevation myocardial infarction had more incidence of MACE than patients with STEMI did in both treatment groups. Frontiers Media S.A. 2022-01-03 /pmc/articles/PMC8761910/ /pubmed/35047571 http://dx.doi.org/10.3389/fcvm.2021.749072 Text en Copyright © 2022 Chang, Lu, Chen, Kuo, Yu, Lin, Shi, Yip and Kao. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Cardiovascular Medicine Chang, Shih-Sheng Lu, Chiung-Ray Chen, Ke-Wei Kuo, Zhe-Wei Yu, Shao-Hua Lin, Shih-Yi Shi, Hong-Mo Yip, Hei-Tung Kao, Chia-Hung Prognosis Between ST-Elevation and Non-ST-elevation Myocardial Infarction in Older Adult Patients |
title | Prognosis Between ST-Elevation and Non-ST-elevation Myocardial Infarction in Older Adult Patients |
title_full | Prognosis Between ST-Elevation and Non-ST-elevation Myocardial Infarction in Older Adult Patients |
title_fullStr | Prognosis Between ST-Elevation and Non-ST-elevation Myocardial Infarction in Older Adult Patients |
title_full_unstemmed | Prognosis Between ST-Elevation and Non-ST-elevation Myocardial Infarction in Older Adult Patients |
title_short | Prognosis Between ST-Elevation and Non-ST-elevation Myocardial Infarction in Older Adult Patients |
title_sort | prognosis between st-elevation and non-st-elevation myocardial infarction in older adult patients |
topic | Cardiovascular Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8761910/ https://www.ncbi.nlm.nih.gov/pubmed/35047571 http://dx.doi.org/10.3389/fcvm.2021.749072 |
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