Document Detail


Efficacy of coronary angioplasty on long-term outcome in elderly Chinese patients with ST elevated myocardial infarction.
MedLine Citation:
PMID:  20411351     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The benefit and efficacy of interventional coronary therapies in elderly patients is still a controversial subject, especially in parts of the world where traditional and conservative medicine is still mainstream. In China, the benefit of intervention is still questionable, hence, this study investigated the prognostic significance of coronary angioplasty on outcomes of elderly patients presenting with ST-segment elevated myocardial infarction (STEMI). The study cohort comprised of 270 elderly (age >or= 75 years) patients who had confirmed STEMI. Some 116 patients underwent coronary angioplasty (called CA group) and their prognoses and survival over the short- and long-term periods (up to 80 months) were compared to 154 comparable patients who received a noninvasive, more conservative medical therapy (non-CA group). The subsequent Kaplan-Meier survival curves and statistical analyses were used to ascertain any difference between the groups. There was no significant differences between the two groups in terms of their clinical presentation, clinical risk, cardiac features, medications and medical procedures, except that the peak creatine kinase was significantly higher in the CA group. The success rate of interventional percutaneous coronary intervention observed in the CA group was 92.4% and during the hospitalization period, there were fewer deaths in the CA group (11 vs. 61 in the non-CA group). Furthermore, after 1-year and up to 7 years postsurgery, the CA group had a significant survival when compared to the non-CA cohort. Analysis of the longer-term data, using multivariate Cox regression analysis after 80 months indicated a hazard ratio of mortality for patients in CA group to be 0.283 (95% CI: 0.140-0.534, P < 0.001). Also, multivariate logistic regression analysis identified conservative treatment, chronic renal failure, cardiac arrhythmia, chronic lung disease and left ventricular ejection fraction, as predictors of higher long-term mortality in elderly patients with STEMI. In conclusion, this study clearly indicates that elderly Chinese patients with STEMI who undergo coronary angioplasty benefit and have a better survival rates in both the short- and long-term.
Authors:
JieYan Shen; YongPing Du; Wei Song; JianPing Liu; ShuXuan Jin; Jun Bu; Ben He
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cell biochemistry and biophysics     Volume:  57     ISSN:  1559-0283     ISO Abbreviation:  Cell Biochem. Biophys.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-28     Completed Date:  2010-09-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9701934     Medline TA:  Cell Biochem Biophys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  59-65     Citation Subset:  IM    
Affiliation:
Department of Cardiology, RenJi Hospital, Shanghai JiaoTong University Medical College, No. 1630, Dong Fang Rd, Shanghai, 200127, People's Republic of China.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary*
China
Creatine Kinase / metabolism
Female
Humans
Male
Myocardial Infarction / mortality,  therapy*
Odds Ratio
Regression Analysis
Survival Rate
Chemical
Reg. No./Substance:
EC 2.7.3.2/Creatine Kinase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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