Document Detail


Is Primary Angioplasty the Best Treatment for AMI in the Elderly?
MedLine Citation:
PMID:  11416524     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The elderly, particularly those over 80, are the fastest growing component of the population. Coronary artery disease accounts for 44% of all deaths in the elderly. Age is also one of the strongest predictors of mortality from acute myocardial infarction (AMI) and in those that survive, long term outcome is worse. In part, the poor inhospital mortality is due to difficulty in diagnosis, but is also likely to be caused by the widespread reluctance to use reperfusion therapy to treat the elderly. Reperfusion therapy has been shown to be equally effective in the elderly, despite an overall increased mortality. The results of randomized trials comparing thrombolysis to angioplasty show an advantage of primary angioplasty over thrombolysis. In the Global Use of Strategies to Open Occluded coronary Arteries in Acute Coronary Syndromes (GUSTO) IIb trial, the advantage was noted in all age groups, including the elderly. The Primary Angioplasty in Myocardial Infarction (PAMI) trial supports these findings. The trials also suggest that the risks are lower with angioplasty than thrombolysis, with a significant lower risk of stroke. Today, with improved outcomes using stents and glycoprotein IIb/IIIa agents, the advantages of primary angioplasty may be even greater than those reported in prior trials. The available data strongly support the use of primary angioplasty in the elderly as an effective reperfusion therapy and, due to improved safety and greater efficacy, should be the preferred treatment in the elderly. (c)1999 by CVRR, Inc.
Authors:
Anil Mehra; David P. Faxon
Related Documents :
17392994 - Inadvertent retrieval of a broken ptca catheter from the aorta during off-pump coronary...
9205024 - Routine platelet transfusion in patients undergoing emergency coronary bypass surgery a...
10884254 - Percutaneous transluminal coronary angioplasty versus medical treatment for non-acute c...
9857884 - Abciximab in primary coronary angioplasty for acute myocardial infarction improves shor...
2807614 - Myocardial infarction associated with a myocardial bridge.
15185914 - Echocardiography in left ventricular dysfunction.
Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  The American journal of geriatric cardiology     Volume:  8     ISSN:  1751-715X     ISO Abbreviation:  Am J Geriatr Cardiol     Publication Date:  1999 Nov 
Date Detail:
Created Date:  2001-Jun-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9215283     Medline TA:  Am J Geriatr Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  282-288     Citation Subset:  -    
Affiliation:
Cardiac Catheterization Laboratory, University of Southern California School of Medicine, LAC+USC Medical Center, Los Angeles, CA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

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


Previous Document:  Hospitalization for Heart Failure in the Elderly.
Next Document:  Anticoagulation of the Elderly Patient.