Benefit of primary percutaneous coronary interventions in the elderly with ST segment elevation myocardial infarction.

Autor:	Fernández-Bergés D; Unidad de Investigación, Hospital Don Benito-Villanueva, Don Benito, Spain polonibo@gmail.com.; Instituto Universitario de Investigación Biosanitaria de Extremadura, Badajoz, Spain., Degano IR; Institut Hospital del Mar d' Investigacions Mediques, Barcelona, Spain., Gonzalez Fernandez R; Department of Cardiology, Infanta Cristina University Hospital, Badajoz, Spain., Subirana I; Institut Hospital del Mar d' Investigacions Mediques, Barcelona, Spain.; CIBERESP de Epidemiologia y Salud Publica, Barcelona, Spain., Vila J; Institut Hospital del Mar d' Investigacions Mediques, Barcelona, Spain.; CIBERESP de Epidemiologia y Salud Publica, Barcelona, Spain., Jiménez-Navarro M; Cardiology Department, Virgen de la Victoria University Hospital, Málaga, Spain., Perez-Fernandez S; CIBER Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain.; Institut Hospital del Mar d'Investigacions Mediques, Barcelona, Spain., Roqué M; Hospital Clinic, Barcelona, Spain., Bayes-Genis A; Department of Cardiology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain., Fernandez-Aviles F; Servicio de Cardiologia, University Hospital Gregorio Marañon, Madrid, Spain., Mayorga A; Department of Cardiology, Hospital Universitario Gregorio Marañón, Madrid, Madrid, Spain., Bertomeu-Gonzalez V; Department of Cardiology, Hospital Universitario de San Juan, Alicante, Spain., Sanchis J; Cardiology Department, Hospital Clinico Universitario, INCLIVA, Universitat de València, Valencia, Spain., Rodríguez Esteban M; Department of Cardiology, Hospital Universitario Nuestra Senora de la Candelaria, Santa Cruz de Tenerife, Spain., Sanchez-Hidalgo A; Consorci Sanitari de Terrassa, Terrassa, Spain., Sanchez-Insa E; Department of Cardiology, Hospital Universitario Miguel Servet, Zaragoza, Spain., Elorriaga A; Department of Cardiology, Hospital Universitario de Basurto, Bilbao, Bilbao, Spain., Abu Assi E; Department of Cardiology, Hospital Álvaro Junqueiro de Vigo, Pontevedra, Vigo, Spain., Nuñez A; Department of Cardiology, Hospital Universitario Fundación de Alcorcón, Madrid, Spain., Garcia Ruiz JM; Hospital Universitario Central de Asturias, Oviedo, Spain., Morrondo Valdeolmillos P; Medicina Intensiva, Hospital Universitario Donostia, San Sebastián, San Sebastian, Spain., Bosch-Portell D; Department of Cardiology, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain., Lekuona I; Department of Cardiology, Hospital Galdakao-Usansolo, Galdacano, Spain., Carrillo-Lopez A; Hospital Universitari Son Espases, Palma de Mallorca, Spain., Zamora A; Hospital Comarcal de Blanes, Blanes, Spain., Vega-Hernandez B; Hospital Universitario de Cabueñes, Gijon, Spain., Alameda Serrano J; Cardiología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain., Rubert C; Hospital Son Llàtzer, Palma de Mallorca, Spain., Ruiz-Valdepeñas L; Hospital General Universitario de Ciudad Real, Ciudad Real, Spain., Quintas L; Hospital de Mendaro, Mendaro, Spain., Rodríguez-Padial L; Complejo Hospitalario de Toledo, Toledo, Spain., Vaquero J; Hospital Universitario Araba sede Txagorritxu, Vitoria-Gasteiz, Spain., Martinez Dolz L; Hospital Universitario La Fe, Valencia, Spain., Barrabes JA; Department of Cardiology, University Hospital Vall d'Hebron, Barcelona, Spain., Sanchez PL; Department of Cardiology, Hospital Universitario Salamanca, Salamanca, Spain., Sionis A; Intensive Cardiac Care Unit, Cardiology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute IIB-Sant Pau, Universitat de Barcelona, Barcelona, Spain., Martí-Almor J; Department of Medicine, Department of Cardiology, Hospital del Mar. Universitat Autónoma de Barcelona, Barcelona, Spain., Elosua R; Institut Hospital del Mar d' Investigacions Mediques, Barcelona, Spain.; CIBER Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain.; Universitat de Vic, Barcelona, Spain., Lidon RM; Hospital Universitari Vall d' Hebron, Barcelona, Spain., Garcia-Dorado D; Hospital Universitari Vall d' Hebron, Barcelona, Spain., Marrugat J; Institut Hospital del Mar d' Investigacions Mediques, Barcelona, Spain.; CIBER Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain.
Jazyk:	angličtina
Zdroj:	Open heart [Open Heart] 2020 Aug; Vol. 7 (2).
DOI:	10.1136/openhrt-2019-001169
Abstrakt:	Objective: Primary percutaneous coronary intervention (P-PCI) has demonstrated its efficacy in patients with ST segment elevation myocardial infarction (STEMI). However, patients with STEMI ≥75 years receive less P-PCI than younger patients despite their higher in-hospital morbimortality. The objective of this analysis was to determine the effectiveness of P-PCI in patients with STEMI ≥75 years. Methods: We included 979 patients with STEMI ≥75 years, from the ATención HOspitalaria del Síndrome coronario study, a registry of 8142 consecutive patients with acute coronary syndrome admitted at 31 Spanish hospitals in 2014-2016. We calculated a propensity score (PS) for the indication of P-PCI. Patients that received or not P-PCI were matched by PS. Using logistic regression, we compared the effectiveness of performing P-PCI versus non-performance for the composite primary event, which included death, reinfarction, acute pulmonary oedema or cardiogenic shock during hospitalisation. Results: Of the included patients, 81.5 % received P-PCI. The matching provided two groups of 169 patients with and without P-PCI. Compared with its non-performance, P-PCI presented a composite event OR adjusted by PS of 0.55 (95% CI 0.34 to 0.89). Conclusions: Receiving a P-PCI was significantly associated with a reduced risk of major intrahospital complications in patients with STEMI aged 75 years or older. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
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