Medicine, Health & Food

Medicine, Health & Food

THE SHORT TERM OUTCOMES OF PERCUTANEOUS CORONARY INTERVENTION AND CONSERVATIVE STRATEGY IN THE VERY ELDERLY PATIENTS WITH ACUTE MYOCARDIAL INFARCTION.

Pages: 6  ,  Volume: 33  ,  Issue: 2 , July   2019
Received: 05 Aug 2019  ,  Published: 06 August 2019
Views: 25  ,  Download: 10

Authors

# Author Name
1 Nguyen Van Tan
2 Nguyen Quoc Khoa

Abstract

Objective: The advantages and disadvantages of percutaneous coronary intervention (PCI) versus conservative medical treatment (CMT) for the very elderly with acute myocardial infarction are still uncertain. To determine the major adverse cardiac events in hospital and at 6 months follow-up of PCI and CMT of acute myocardial infarction (AMI) on the very elderly patients is purpose of this study.

Patients and Methods: A descriptive study with cohort, prospective and multi centers. From June 2017 to June 2018, 275 patients (≥ 80 years old) with AMI were enrolled. All patients were divided into 2 groups included a CMT group (n=133) and a PCI group (n=142). 

Results: In-hospital mortality of the CMT group was significant higher than PCI group (18.05% vs 8.45%, p = 0.018). The cardiovascular mortality and recurrent myocardial infarction (MI) after 6months follow-up were still significant higher in CMT group than those PCI group (respectively, 15.75% vs 8.45%, p=0.002; 15.75% vs 3.45%, p=0.001). The two strategies did not differ in term of stroke and major bleeding.  

Conclusions: In treatment of AMI in the very elderly patients, PCI is superior to CMT in the reduction of in-hospital mortality and 6-month cardiovascular mortality as well as recurrent MI.

Keywords

  • acute myocardial infarction
  • References

    1. Alexander K. P., et al. (2007). "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". Circulation, 115 (19), 2570-89.

    2. Amsterdam E. A.,et al. (2014). "2014 AHA/ACC Guideline for the Management of Patients with Non-ST-Elevation Acute Coronary Syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines". J Am Coll Cardiol, 64 (24), e139-e228.

    3. Devlin G.,et al. (2008). "Management and 6-month outcomes in elderly and very elderly patients with high-risk non-ST-elevation acute coronary syndromes: The Global Registry of Acute Coronary Events". Eur Heart J, 29 (10), 1275-82.

    4. Gierlotka M.,et al. (2013). "Outcomes of invasive treatment in very elderly Polish patients with non-ST-segment-elevation myocardial infarction from 2003-2009 (from the PL-ACS registry)". Cardiol J, 20 (1), 34-43

    5. Hicks K. A., et al. (2015). "2014 ACC/AHA Key Data Elements and Definitions for Cardiovascular Endpoint Events in Clinical Trials: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Cardiovascular Endpoints Data Standards)". J Am Coll Cardiol, 66 (4), 403-69

    6. Kashima K., et al. (2010). "Mid-term mortality of very elderly patients with acute myocardial infarction with or without coronary intervention". J Cardiol, 55 (3), 397-403.

    7. Lee P. Y., et al (2001). "Representation of elderly persons and women in published randomized trials of acute coronary syndromes". Jama, 286 (6), 708-13.

    8. O'Gara P. T., et al. (2013). "2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". J Am Coll Cardiol, 61 (4), 485-510.

    9. Roffi M., et al. (2016). "2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC)". Eur Heart J, 37 (3), 267-315.

    10. Thygesen K.,et al. (2012). "Third universal definition of myocardial infarction". Circulation, 126 (16), 2020-35

    11. Yudi M. B.,et al. (2016). "Management of Patients Aged >=85 Years With ST-Elevation Myocardial Infarction". Am J Cardiol, 118 (1), 44-8