1. Benefit of primary percutaneous coronary interventions in the elderly with ST segment elevation myocardial infarction
- Author
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Luis Rodríguez-Padial, Mercè Roqué, Irene R. Dégano, Pedro Morrondo Valdeolmillos, Berta Vega-Hernandez, David Garcia-Dorado, Iñaki Lekuona, Pedro L. Sánchez, Rosa-Maria Lidón, Antonio Mayorga, Silvia Pérez-Fernández, Joan Vila, Alberto Núñez, Jaume Marrugat, José A. Barrabés, Daniel Bosch-Portell, Antonio Sanchez-Hidalgo, Julio Martí-Almor, Francisco Fernández-Avilés, Andres Carrillo-Lopez, Manuel F. Jiménez-Navarro, Daniel Fernández-Bergés, Marcos Rodríguez Esteban, Roberto Elosua, Laura Quintas, Javier Alameda Serrano, Emad Abu Assi, Reyes Gonzalez Fernandez, Jose Manuel Garcia Ruiz, Luis Martínez Dolz, Ane Elorriaga, Alessandro Sionis, Jessica Vaquero, Antoni Bayes-Genis, Esther Sanchez-Insa, Catalina Rubert, Vicente Bertomeu-González, Isaac Subirana, Alberto Zamora, Luis Ruiz-Valdepeñas, and Juan Sanchis
- Subjects
Male ,Time Factors ,Percutaneous ,sistema de registros ,medicine.medical_treatment ,humanos ,Comorbidity ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Logistic regression ,0302 clinical medicine ,Recurrence ,Risk Factors ,evaluación de riesgos ,ST segment ,Registries ,030212 general & internal medicine ,Myocardial infarction ,Aged, 80 and over ,anciano ,coronary intervention (PCI) ,resultado del tratamiento ,Cardiogenic shock ,Age Factors ,Shock ,stemi ,Treatment Outcome ,surgical procedures, operative ,Cardiology ,Female ,Acute coronary syndrome ,Cardiology and Cardiovascular Medicine ,Stemi ,medicine.medical_specialty ,Shock, Cardiogenic ,Pulmonary Edema ,Risk Assessment ,acute coronary syndrome ,edema pulmonar ,03 medical and health sciences ,factores de tiempo ,Percutaneous Coronary Intervention ,choque ,cirugía coronaria percutánea ,Internal medicine ,medicine ,factores de riesgo ,Humans ,cardiovascular diseases ,Aged ,Coronary intervention (PCI) ,business.industry ,Percutaneous coronary intervention ,medicine.disease ,Spain ,Propensity score matching ,ST Elevation Myocardial Infarction ,business ,recurrencia - Abstract
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., Supported by: MARATO TV3 (081630), de AGAUR (2014SGR240); del Instituto de Salud Carlos III: Red de Investigacion Cardiovascular RD12/0042 (Programa HERACLES); Red RedIAPP RD06/0018; CP12/03287; CIBER Epidemiologia y Salud Publica; CIBERCV de enfermedades Cardiovasculares, Fondo Europeo de Desarrollo Regional (FEDER) (European Regional Development Funds - ERDF-); FIS CP12/03287, FIS 14/00449, FIS PI081327, FIS INTRASALUD PI1101801.
- Published
- 2020
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