Changes in treatment for NSTEMI in women and the elderly over the past 16 years in a large real-world population
| Autor: | R Schoeller, Steffen Behrens, Helmut Schühlen, David M. Leistner, Leonhard Riehle, Martin Stockburger, Georg M. Fröhlich, Ulf Landmesser, Birga Maier, Leonhard Bruch, Heinz Theres |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty medicine.medical_treatment Population Myocardial Infarction 030204 cardiovascular system & hematology Revascularization Coronary artery disease 03 medical and health sciences Percutaneous Coronary Intervention 0302 clinical medicine Age groups Risk Factors Humans Medicine Registries 030212 general & internal medicine Myocardial infarction Non-ST Elevated Myocardial Infarction education Aged education.field_of_study business.industry Drug-Eluting Stents World population medicine.disease Treatment Outcome Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | International Journal of Cardiology. 316:7-12 |
| ISSN: | 0167-5273 |
| DOI: | 10.1016/j.ijcard.2020.04.021 |
| Popis: | This study investigates the changes in therapy for Non-ST-Elevation Myocardial Infarction (NSTEMI) over the past 16 years in a large German registry. In particular, the high-risk population of female and elderly patients was analyzed.In total, 19.383 patients presenting with NSTEMI were included in this study. Patients were stratified by age groups75 years and ≥75 years and by sex. Four different time periods from 2000-2004, 2005-2008, 2009-2012 and 2013-2016 were compared. Influence on hospital mortality as the primary outcome measure was assessed by logistic regression analysis. Secondary outcome measures included percutaneous coronary intervention (PCI), the use of drug eluting stents (DES), radial access route and major adverse cardiovascular events (MACE), defined as all-cause mortality, stroke, re-infarction, percutaneous re-intervention, intervention-related bleeding, cardiopulmonary resuscitation and new onset of cardiogenic shock or need for mechanical ventilation.Mortality decreased in all age groups between the initial time period and the most recent one (8.9% vs. 4.5%, p 0.01), particularly in female patients ≥75 years (18.2% in 2000-2004 vs. 7.9% in 2013-2016, p 0.01). Revascularization rates differed by gender (68.3% in women vs. 78.1% in men, p 0.01) and by age (64.2% for ≥75 years vs. 80.9% for75 years, p 0.01). PCI rates in elderly female patients increased from 28.7% to 69.8% (p 0.01) from the initial to the latest period.The present study demonstrates, that revascularization rates improved in all patient groups over the study period. However, females and elderly patients still remain less likely to be treated according to current guidelines. |
| Databáze: | OpenAIRE |
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