KALA, Petr, Jan KAŇOVSKÝ, Richard ROKYTA, Michal SMID, Jan POSPISIL, Jiri KNOT, Filip ROHAC, Martin POLOCZEK, Tomáš ONDRÚŠ, Mária HOLICKÁ, Jindřich ŠPINAR, Jiří JARKOVSKÝ a Ladislav DUŠEK. Age – related treatment strategy and long-term outcome in acute myocardial infarction patients in the PCI era. BMC Cardiovascular Disorders. 2012, roč. 12, č. 31, s. "nestrankovano", 6 s. ISSN 1471-2261. doi:10.1186/1471-2261-12-31.
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Základní údaje
Originální název Age – related treatment strategy and long-term outcome in acute myocardial infarction patients in the PCI era
Autoři KALA, Petr (203 Česká republika, garant, domácí), Jan KAŇOVSKÝ (203 Česká republika, domácí), Richard ROKYTA (203 Česká republika), Michal SMID (203 Česká republika), Jan POSPISIL (203 Česká republika), Jiri KNOT (203 Česká republika), Filip ROHAC (203 Česká republika), Martin POLOCZEK (203 Česká republika, domácí), Tomáš ONDRÚŠ (703 Slovensko, domácí), Mária HOLICKÁ (703 Slovensko, domácí), Jindřich ŠPINAR (203 Česká republika, domácí), Jiří JARKOVSKÝ (203 Česká republika, domácí) a Ladislav DUŠEK (203 Česká republika, domácí).
Vydání BMC Cardiovascular Disorders, 2012, 1471-2261.
Další údaje
Originální jazyk angličtina
Typ výsledku Článek v odborném periodiku
Obor 30201 Cardiac and Cardiovascular systems
Stát vydavatele Velká Británie
Utajení není předmětem státního či obchodního tajemství
WWW článek pouze online, open access
Impakt faktor Impact factor: 1.457
Kód RIV RIV/00216224:14110/12:00060595
Organizační jednotka Lékařská fakulta
Doi http://dx.doi.org/10.1186/1471-2261-12-31
UT WoS 000306842300001
Klíčová slova anglicky acute myocardial infarction; treatment; Older age; Retrospective multicenter analysis
Příznaky Mezinárodní význam
Změnil Změnila: Soňa Böhmová, učo 232884. Změněno: 22. 4. 2013 15:14.
Anotace
Older age, as a factor we cannot affect, is consistently one of the main negative prognostic values in patients with acute myocardial infarction. One of the most powerful factors that improves outcomes in patients with acute coronary syndromes is the revascularization preferably performed by percutaneous coronary intervention. No data is currently available for the role of age in large groups of consecutive patients with PCI as the nearly sole method of revascularization in AMI patients. The aim of this study was to analyze age-related differences in treatment strategies, results of PCI procedures and both in-hospital and long-term outcomes of consecutive patients with acute myocardial infarction. Methods Retrospective multicenter analysis of 3814 consecutive acute myocardial infarction patients divided into two groups according to age (1800 patients lower than 65 years and 2014 patients>65 years). Significantly more older patients had a history of diabetes mellitus and previous myocardial infarctions. Results The older population had a significantly lower rate of coronary angiographies (1726; 95.9% vs. 1860; 92.4%, p<0.0001), PCI (1541; 85.6% vs. 1505; 74.7%, p<0.001), achievement of optimal final TIMI flow 3 (1434; 79.7% vs. 1343; 66.7%, p<0.001) and higher rate of unsuccessful reperfusion with final TIMI flow 0-1 (46; 2.6% vs. 78; 3.9%, p=0.022). A total of 217 patients (5.7%) died during hospitalization, significantly more often in the older population (46; 2.6% vs. 171; 8.5%, p<0.001). The long-term mortality (data for 2847 patients from 2 centers) was higher in the older population as well (5 years survival: 86.1% vs. 59.8%). Though not significantly different and in contrast with PCI, the presence of diabetes mellitus, previous MI, final TIMI flow and LAD, as the infarct-related artery, had relatively lower impact on the older patients. Severe heart failure on admission (Killip III-IV) was associated with the worst prognosis in the whole group of patients, though its significance was higher in the youngers (HR 6.04 vs. 3.14, p=0.051 for Killip III and 12.24 vs. 5.65, p=0.030 for Killip IV). We clearly demonstrated age as a strong discriminator for the whole population of AMI patients. Conclusions In a consecutive AMI population, the older group (>65 years) was associated with a less pronounced impact of risk factors on long-term outcome. To ascertain the coronary anatomy by coronary angiography and proceed to PCI if suitable regardless of age is crucial in all patients, though the primary success rate of PCI in the older age is lower. Age, when viewed as a risk factor, was a dominant discriminating factor in all patients.
Návaznosti
MSM0021622402, záměrNázev: Časná diagnostika a léčba kardiovaskulárních chorob
Investor: Ministerstvo školství, mládeže a tělovýchovy ČR, Časná diagnostika a léčba kardiovaskulárních chorob
VytisknoutZobrazeno: 25. 5. 2022 09:38