Back to Search
Start Over
Impact of Prior Coronary Artery Bypass Grafting in Patients ≥75 Years Old Presenting With Acute Myocardial Infarction (From the National Readmission Database)
- Source :
- The American Journal of Cardiology. 135:9-16
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Patients ≥75 years old presenting with acute myocardial infarction (AMI) have complex coronary anatomy in part due to prior coronary artery bypass grafting (CABG), percutaneous coronary interventions (PCI), calcific and valvular disease. Using the National Readmission Database from January 2016 to November 2017, we identified hospital admissions for acute myocardial infarction in patients ≥75 years old and divided them based on a history of CABG. We evaluated in-hospital outcomes, 30-day mortality, 30-day readmission and predictors of PCI in cohorts. Out of a total of 296,062 patients ≥75 years old presenting with an AMI, 42,147 (14%) had history of previous CABG. Most presented with a non-ST segment elevation myocardial infarction, and those with previous CABG had higher burden of co-morbidities and were more commonly man. The in-hospital mortality was significantly lower in those with previous CABG (6.7% vs 8.8%, adjusted odds ratio, 0.88, 95% confidence interval, 0.82 to 0.94). Medical therapy was more common in those with previous CABG and 30-day readmission rates were seen more frequently in those with prior CABG. Predictors of not undergoing PCI included previous PCI, female, older ager groups, heart failure, dementia, malignancy, and higher number of co-morbidities. In conclusion, in patients ≥75 years old with AMI the presence of prior CABG was associated with lower odds of in-hospital and 30-day mortality, as well as lower complications rates, and a decreased use of invasive strategies (PCI, CABG, and MCS). However, 30-day MACE readmission was higher in those with previous CABG.
- Subjects :
- Male
medicine.medical_specialty
Percutaneous
Databases, Factual
Myocardial Infarction
030204 cardiovascular system & hematology
computer.software_genre
Patient Readmission
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Internal medicine
Humans
Medicine
cardiovascular diseases
030212 general & internal medicine
Myocardial infarction
Coronary Artery Bypass
Aged
Aged, 80 and over
Database
business.industry
Odds ratio
medicine.disease
United States
Confidence interval
Treatment Outcome
surgical procedures, operative
Heart failure
Conventional PCI
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
computer
Mace
Cohort study
Subjects
Details
- ISSN :
- 00029149
- Volume :
- 135
- Database :
- OpenAIRE
- Journal :
- The American Journal of Cardiology
- Accession number :
- edsair.doi.dedup.....d7fa6b1f9d678bab98762a48765e8c79