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

Objective 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 ob...

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Detalles Bibliográficos
Autores: Fernandez-Berges, D, Degano, IR, Fernandez, RG, Subirana, I, Vila, J, Jimenez-Navarro, M, Perez-Fernandez, S, Roque, M, Bayes-Genis, A, Fernandez-Aviles, F, Mayorga, A, Bertomeu-Gonzalez, V, Sanchis, J, Esteban, MR, Sanchez-Hidalgo, A, Sanchez-Insa, E, Elorriaga, A, Abu Assi, E, Nunez, A, Ruiz, JMG, Valdeolmillos, PM, Bosch-Portell, D, Lekuona, I, Carrillo-Lopez, A, Zamora, A, Vega-Hernandez, B, Serrano, JA, Rubert, C, Ruiz-Valdepenas, L, Quintas, L, Rodriguez-Padial, L, Vaquero, J, Martinez Dolz, L, Barrabes, JA, Sanchez, PL, Sionis, A, Marti-Almor, J, Elosua, R, Lidon, RM, Garcia-Dorado, D, Marrugat, J, ATHOS Investigators
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Institución:Consejo Superior de Investigaciones Científicas (CSIC)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p8179
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/8179
Access Level:acceso abierto
Palabra clave:coronary intervention (PCI)
stemi
acute coronary syndrome
Descripción
Sumario:Objective 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. Methods We included 979 patients with STEMI >= 75 years, from the ATencion HOspitalaria del Sindrome 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. Results 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). Conclusions 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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