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Benefits from revascularisation therapy in the elderly with acute myocardial infarction. Comparative analysis of patients hospitalised in 1992-1996 and in 2005-2006.
MedLine Citation:
PMID:  20730715     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Coronary artery disease in the elderly is associated with multilevel atherosclerosis and chronic co-morbidities. AIM: To determine benefits from revascularisation in the elderly. METHODS: A total of 830 patients over 65 years with ST-segment elevation myocardial infarction (STEMI) were included. Of them, 339 admitted in 1992-1996 (38.5% STEMI population hospitalised in 1992-1996) (group 1) and 491 (55.2% STEMI population) admitted in 2005-2006 (group 2) were compared. We examined patient characteristics, the course of hospitalisation, the type of therapy and its effect on in-hospital and long-term prognosis (6-month follow-up). RESULTS: The proportion of patients over 65 has increased significantly from 38.5% in 1992-1996 to 55.2% in 2005-2006 (p < 0.001). In 1992-1996 fibrinolysis was administered in 11.2% of patients while 88.8% received conservative treatment. In 2005-2006 reperfusion therapy was used in 52.2% of patients (15.1% fibrinolysis, 37.1% primary angioplasty). The in-hospital and 6-month mortality tended to be lower in the more recent group (21.5% v. 18.5% and 28% v. 23.8%, NS, respectively). In group 1 there were 22.6% of deaths among those receiving conservative treatment versus 13.2% in patients submitted to reperfusion (p = 0.18). In group 2 in-hospital mortality was the lowest in patients undergoing invasive treatment which was associated with a 62% decrease in 6-month mortality as compared with those receiving conservative treatment (p < 0.001). CONCLUSIONS: Invasive treatment significantly improves in-hospital and long-term survival in older patients with STEMI. Lack of mortality reduction was related to worse clinical presentation of the currently hospitalised older patient.
Authors:
Anna Polewczyk; Marianna Janion; Mariusz Gasior; Marek Gierlotka; Lech Poloński
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Kardiologia polska     Volume:  68     ISSN:  0022-9032     ISO Abbreviation:  Kardiol Pol     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376352     Medline TA:  Kardiol Pol     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  873-81     Citation Subset:  IM    
Affiliation:
2nd Department of Cardiologu, Swietokrzyskie Cardiology Centre, District Hosptial, Kielce, Poland. AnnaPolewczyk@wp.pl
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Comment In:
Kardiol Pol. 2010 Aug;68(8):882-3   [PMID:  20730716 ]

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