Document Detail


The role of invasive therapies in elderly patients with acute myocardial infarction.
MedLine Citation:
PMID:  19578659     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: In elderly patients with acute myocardial infarction, very little is known about the role of surgical myocardial revascularization and percutaneous coronary intervention (invasive therapies--IT), especially in the context of long-term outcomes after hospital discharge.
METHODS: We analyzed 1588 patients with MI who had been included prospectively in a databank and followed for up to 7.5 years. In this population, 548 patients were >70 years old (elderly group--EG), and 1040 were <70 years of age (younger group--YG); 1088 underwent IT during hospitalization, and the remaining 500 were treated medically (conservative therapy--CT). Patients were monitored either by visit or by phone at least once a year. A standard questionnaire was administered to all patients. The impact of IT was analyzed with both non-adjusted and adjusted models.
RESULTS: By the end of the follow-up period, the survival rates for the IT and CT groups were, respectively, 71.9% versus 47.2% in the global population (hazard ratio=0.55, P<0.001), 81.5% versus 66.6% in the YG (hazard ratio=0.68, P=0.018) and 48.8% versus 20.3% in the EG (hazard ratio=0.58, P<0.001). In the adjusted models, the hazard ratios were 0.62 (P<0.001) in the global population, 0.74 in the YG (P=0.073) and 0.64 (P=0.001) in the EG.
CONCLUSION: Long-term follow-up of patients with myocardial infarction revealed that IT during the in-hospital phase was at least as effective in elderly patients as in younger patients.
Authors:
José C Nicolau; Pedro A Lemos; Maurício Wajngarten; Roberto R Giraldez; Carlos V Serrano; Eulógio E Martinez; Luciano M Baracioli; Roberto Kalil; Fábio B Jatene; Luis A Dallan; Luis B Puig; Noedir A Stolf
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinics (São Paulo, Brazil)     Volume:  64     ISSN:  1980-5322     ISO Abbreviation:  Clinics (Sao Paulo)     Publication Date:  2009  
Date Detail:
Created Date:  2009-07-06     Completed Date:  2010-12-20     Revised Date:  2013-05-23    
Medline Journal Info:
Nlm Unique ID:  101244734     Medline TA:  Clinics (Sao Paulo)     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  553-60     Citation Subset:  IM    
Affiliation:
Acute Coronary Disease Unit, Faculdade de Medicina, Heart Institute, Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil. corjnicolau@incor.usp.br
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Angioplasty, Balloon, Coronary / mortality*
Coronary Artery Bypass / mortality*
Female
Follow-Up Studies
Humans
Long-Term Care
Male
Myocardial Infarction / mortality,  therapy*
Prospective Studies
Sex Factors
Survival Rate
Treatment Outcome
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