Evolution of REperfusion Strategies and impact on mortality in Old and Very OLD STEMI patients. The RESOVOLD-e-MUST study.

Autor:	Lapostolle F; SAMU 93, UF Recherche-Enseignement-Qualité, Avicenne Hospital-APHP, Bobigny, France.; Université Paris 13, INSERM Unit 942, Sorbonne Paris Cité, Bobigny, France., Petrovic T; SAMU 93, UF Recherche-Enseignement-Qualité, Avicenne Hospital-APHP, Bobigny, France.; Université Paris 13, INSERM Unit 942, Sorbonne Paris Cité, Bobigny, France., Moiteaux B; Data Science Department, Sesan, Paris, France., Loyeau A; Data Science Department, Sesan, Paris, France., Boche T; SAMU 94, Mondor Hospital-APHP, Créteil, France., Kadji Kalabang R; SAMU 77, Melun Hospital, Melun, France., Le Bail G; SAMU 92, Garches Hospital, Garches, France., Lamhaut L; SAMU 75, Necker Hospital-APHP, Paris, France., Lafay M; SAMU 91, Sud Francilien Hospital, Corbeil-Essonnes, France., Dupas F; SAMU 95, Pontoise Hospital, Pontoise, France., Scannavino M; EMS Department, Fire Departement of Paris, France., Benamer H; Cardiology Department, Institut Cardiovasculaire Paris Sud (ICPS), Massy, France., Bataille S; Regional Health Agency in Great Paris Area, Paris, France., Lambert Y; SAMU 78, Versailles Hospital, Le Chesnay, France.
Jazyk:	angličtina
Zdroj:	Age and ageing [Age Ageing] 2024 Jan 02; Vol. 53 (1).
DOI:	10.1093/ageing/afad215
Abstrakt:	Background: The use of myocardial reperfusion-mainly via angioplasty-has increased in our region to over 95%. We wondered whether old and very old patients have benefited from this development. Methods: Setting: Greater Paris Area (Ile-de-France). Data: Regional registry, prospective, including since 2003, data from 39 mobile intensive care units performing prehospital treatment of patients with ST segment elevation myocardial infarction (STEMI) (<24 h). Parameters: Demographic, decision to perform reperfusion and outcome (in-hospital mortality). Primary Endpoint: Reperfusion decision rate by decade over age 70. Secondary Endpoint: Outcome. Results: We analysed the prehospital management of 27,294 patients. There were 21,311 (78%) men and 5,919 (22%) women with a median age of 61 (52-73 years). Among these patients, 8,138 (30%) were > 70 years, 3,784 (14%) > 80 years and 672 (2%) > 90 years.The reperfusion decision rate was 94%. It decreased significantly with age: 93, 90 and 76% in patients in their seventh, eighth and ninth decade, respectively. The reperfusion decision rate increased significantly over time. It increased in all age groups, especially the higher ones. Mortality was 6%. It increased significantly with age: 8, 16 and 25% in patients in their seventh, eighth and ninth decade, respectively. It significantly decreased over time in all age groups. The odds ratio of the impact of reperfusion decision on mortality reached 0.42 (0.26-0.68) in patients over 90 years. Conclusion: the increase in the reperfusion decision rate was the greatest in the oldest patients. It reduced mortality even in patients over 90 years of age. (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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