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

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...

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Autores: Fernández-Bergés, Daniel|||0000-0002-9561-2901, Degano, Irene R.|||0000-0003-1914-6934, Gonzalez Fernandez, Reyes, Subirana, Isaac|||0000-0003-1676-0197, Vila, Joan, Jiménez-Navarro, Manuel|||0000-0002-6759-0514, Pérez-Fernández, Silvia|||0000-0002-9756-0092, Roqué, Mercè, Bayés-Genís, Antoni|||0000-0002-3044-197X, Fernández Avilés, Francisco|||0000-0001-5501-5275, Mayorga, Antonio, Bertomeu-González, Vicente|||0000-0001-5309-0562, Sanchis, Juan|||0000-0003-0797-8709, Rodríguez Esteban, Marcos, Sánchez Hidaldo, Antonio|||0000-0003-0710-3160, Sanchez-Insa, Esther, Elorriaga, Ane, Abu-Assi, Emad|||0000-0003-1568-3118, Nuñez, Alberto, Garcia Ruiz, Jose Manuel, Morrondo Valdeolmillos, Pedro, Bosch-Portell, Daniel, Lekuona, Iñaki, Carrillo-Lopez, Andres, Zamora, Alberto|||0000-0001-6907-0654, Vega-Hernandez, Berta, Alameda Serrano, Javier, Rubert, Catalina, Ruiz-Valdepeñas, Luis, Quintas, Laura, Rodríguez-Padial, Luis|||0000-0002-5783-3922, Vaquero, Jessica, Martinez Dolz, Luis, Barrabés, José A.|||0000-0001-7062-6277, Sánchez Fernández, Pedro Luis|||0000-0002-1402-0526, Sionis, Alessandro|||0000-0003-0843-9512, Martí-Almor, Julio|||0000-0001-9927-1190, Elosua, Roberto|||0000-0001-8235-0095, Lidón, Rosa María|||0000-0001-7008-2716, García-Dorado, David|||0000-0002-1126-1279, Marrugat, Jaume|||0000-0003-3320-554X
Tipo de recurso: artículo
Fecha de publicación:2020
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:231255
Acceso en línea:https://ddd.uab.cat/record/231255
https://dx.doi.org/urn:doi:10.1136/openhrt-2019-001169
Access Level:acceso abierto
Palabra clave:Coronary intervention (PCI)
Stemi
Acute coronary syndrome
Descripción
Sumario: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. 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. 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). Receiving a P-PCI was significantly associated with a reduced risk of major intrahospital complications in patients with STEMI aged 75 years or older.

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