Benefit of primary percutaneous coronary interventions in the elderly with ST segment elevation myocardial infarction

Fernandez-Berges, D. ; Degano, I.R. ; Fernandez, R.G. ; Subirana, I. ; Vila, J. ; Jimenez-Navarro, M. ; Perez-Fernandez, S. ; Roque, M. ; Bayes-Genis, A. ; Fernandez-Aviles, F. ; Mayorga, A. ; Bertomeu-Gonzalez, V. ; Sanchis, J. ; Esteban, M.R. ; Sanchez-Hidalgo, A. ; Sanchez-Insa, E. ; Elorriaga, A. ; Abu Assi, E. ; Nunez, A. ; Ruiz, J.M.G. ; Valdeolmillos, P.M. ; Bosch-Portell, D. ; Lekuona, I. ; Carrillo-Lopez, A. ; Zamora, A. ; Vega-Hernandez, B. ; Serrano, J.A. ; Rubert, C. ; Ruiz-Valdepenas, L. ; Quintas, L. ; Rodriguez-Padial, L. ; Vaquero, J. ; Martinez Dolz, L. ; Barrabes, J.A. ; Sanchez, P.L. ; Sionis, A. ; Marti-Almor, J. ; Elosua, R. ; Lidon, R.M. ; Garcia-Dorado, D. ; Marrugat, J.

Resumen: 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.

Idioma: Inglés

DOI: 10.1136/openhrt-2019-001169

Año: 2020

Publicado en: Open Heart 7, 2 (2020), e001169 [7 pp]
ISSN: 2053-3624

Factor impacto SCIMAGO: 1.05 - Cardiology and Cardiovascular Medicine (Q1)

Financiación: info:eu-repo/grantAgreement/ES/FEDER/FIS-CP12-03287
Financiación: info:eu-repo/grantAgreement/ES/FEDER/FIS-INTRASALUD-PI1101801
Financiación: info:eu-repo/grantAgreement/ES/FEDER/FIS-PI081327
Financiación: info:eu-repo/grantAgreement/ES/FEDER/FIS-14-00449
Financiación: info:eu-repo/grantAgreement/ES/ISCIII/CP12-03287
Financiación: info:eu-repo/grantAgreement/ES/ISCIII/RD06-0018
Financiación: info:eu-repo/grantAgreement/ES/ISCIII/RD12-0042-HERACLES

Tipo y forma: Article (Published version)