The role of myocardial revascularization surgery and percutaneous coronary intervention in the long-term follow-up of elderly patients with myocardial infarction
| Autor: | Michael Sprafka, J. C. Nicolau, Marcelo Franken, JoséA. Ramires, Luciano Moreira Baracioli, Renata Teixeira Ladeira, Jose M. Brum, Luis F. Seguro |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
medicine.medical_specialty
education.field_of_study Myocardial revascularization business.industry Long term follow up medicine.medical_treatment Mortality rate Population Electrocardiography in myocardial infarction Percutaneous coronary intervention medicine.disease symbols.namesake Internal medicine Cardiology symbols Medicine Myocardial infarction business education Cardiology and Cardiovascular Medicine Fisher's exact test |
| Zdroj: | Journal of the American College of Cardiology. 41(6) |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/s0735-1097(03)81868-5 |
| Popis: | Background: Little is known, especially in the elderly, about the role of surgical myocardial revascularization and percutaneous coronary intervention (invasive procedures IP) in the long-term follow-up of pts with acute myocardial infarction (AMI), aim of this study. Methods: we analyzed 481 pts with AMI included prospectively and consecutively in a databank and followed for up to 4 years (mean survival time 3.15 y). During the in-hospital phase, 309 pts were submitted to IP (64.2%). and 151 (31.4%) were older than 69 years. Pearson Chi-square, Fisher exact test and Two-sample t-test ware utilized for the m-hospital analysis; Kaplan-Mr the mortality rates for the subgroups submitted to IP @x=85) or treated conservatively were. respectively, 18.8% and 24.2% (O&0.78. ~~0.53); for pts younger than 70 y, the mortality rate was 5.5%; the mortality rates for the invasive (n=224) or conservative subgroups were 6.2% and 4.7%, respectively (ORzl.35, p=O.58). (b) Long-term follow-up analysis: the unadjusted swwal rates for mvasive and conservative groups in the whole population were, respectively, 83.1% f 2.3 and 70.6% + 3.8 (p=O.O07); in the subgroup of pts older than 69 y the survival rates were 74.8% + 4.8 and 49.7% * 7, respectively (p=O.O35); in the subgroup of pts younger than 70 y, the sutvrval rates were 863% 4 2.5 and 83.1% + 3.9 (p=O.7). Adjusted survival rates: 80 + 1.7 and 46.82 3.2 for the elderly population (p=O.O35); 87.2 -+ 1.3 and 82.5 + 2.0 for younger pts (p=O.7). SurvivalI rates excluding 83 pts treated with primary angioplasty: in the elderly group, 78.2 + 5.4 and 49.7 + 7.0 (p=O.Ol I); in the younger group 86.8 -+ 2.8 and 83.1 + 3.9 (p=O.56). Concluston: in the long-term follow-up post-AMI. the invasive strategy was more efficacious in elderly patients. |
| Databáze: | OpenAIRE |
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