Clinical Presentation and Outcomes in Real-Life Management of Elderly Patients Aged ≥75 Years Presenting with Acute Myocardial Infarction
| Autor: | Ozdogan, Oner, Kayikcioglu, Meral, Kilickap, Mustafa, Ekmekci, Cenk, Kucukukur, Murat, Yalcin, Ahmet Arif, Erol, Mustafa Kemal |
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| Rok vydání: | 2022 |
| Předmět: |
Risk
preventive cardiology Predictors Global Registry Angioplasty Events Myocardial Infarction Intervention Acute myocardial infarction PTCA/PCI Coronary Angiography Impact Percutaneous Coronary Intervention Treatment Outcome Risk Factors Humans Women Hospital Mortality Registries Acute Coronary Syndromes coronary artery disease Platelet Aggregation Inhibitors Aged |
| Zdroj: | Anatolian journal of cardiology. 26(4) |
| ISSN: | 2149-2271 |
| Popis: | Background: The aim of this study was to provide insight into the real-life clinical presentation and outcomes of the elderly presenting with acute myocardial infarction from the Turkish Myocardial Infarction registry database. Methods: TURKMI was a nationwide, multicenter, observational, 15-day snapshot registry conducted to address the management of acute myocardial infarction patients admitted to percutaneous intervention-capable hospitals. The present analysis included the comparison of consecutively enrolled acute myocardial infarction patients aged >= 75 and = 75 years. Elderly patients were more likely to have hypertension and renal failure and less likely to have hypercholesterolemia. Elderly patients were admitted to hospitals almost 1 hour later mainly due to a late call to emergency medical service. At discharge, medical therapies were significantly less prescribed to the elderly. The proportion of patients undergoing coronary angiography was significantly lower in elderly (81.8% vs. 96.4%, P < .001). Both in-hospital and 1-year mortality were significantly higher in elderly patients (9.1% vs. 2.7% and 22.7% vs. 5.8%, P < .001 respectively). The adjusted risk of 1-year mortality was 4-fold in elderly (hazard ratio and 95% CI 4.0 [2.9-5.6], P < .001). In multivariate analysis, every 5-beat/min increase in heart rate increased mortality by 7%. Higher heart rate and use of antiplatelet agents on admission were predictors of mortality in elderly. Conclusion: In real-life settings, elderly patients presenting with acute myocardial infarction are prone to prolonged total ischemic time and are subjected to less-intensive medical treatment and interventional approaches. Besides age, the increased heart rate could be the major determinant of mortality. |
| Databáze: | OpenAIRE |
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