Preview

Сибирский научный медицинский журнал

Advanced search

Percutaneous coronary interventions for ST elevation myocardial infarction in different age groups

https://doi.org/10.18699/SSMJ20210208

Abstract

Given the global trend of population aging, it is natural to see an increase in the number of percutaneous coronary interventions (PCI) performed in patients of older age groups.The aim of this study was to compare the results of percutaneous coronary interventions (PCI) in different age groups and find a predictors of hospital mortality. Methods. Data were collected from 1649 patients with STEMI who were admitted to the coronary care unit and underwent PCIs from
2006 to 2017. Patients were divided into 3 age groups according to World Heals Organization classification. The first group consisted of 850 patients aged from 18 to 59 years, the second group consisted 620 patients aged from 60 to 74 years, and third group consisted of 179 patients aged from 75 years and older. Results. The rate of in-hospital death was statistically significant lower in younger groups (groups 1-2: 2.2 % vs 5.8 %, р<0.001; groups 1-3: 2.2 % vs 16.2 %, р<0.001; 2-3: 5.8 % vs 16.2 %, р<0.001). After multivariate adjustment the independent predictor of death were age (odds ratio (OR) =1.08; 95 % confidence interval (CI) 1.05-1.11, р<0.001), anterior myocardial infarction (OR=2.03; 95 % CI 1.15-3.59, р=0.015), Syntax score (OR=1.05; 95 % CI 1.02-1.09, р=0.001), ventricular arrhythmias (OR=4.98; 95 % CI 2.49-9.96, р<0.001), blood glucose level at admission (OR=1.06; 95 % CI 1.01-1.13, р=0.040), PCI failure (OR=5.05; 95 % CI 2.47-10.3, р<0.001), Killip class III-IV (OR=6.01; 95 % CI 3.12–11.6, р<0.001), total ischemia t-me >180 minutes (OR=4.39; 95 % CI 1.78-10.8, р=0.001). Conclusions. PCIs for STEMI in older age groups were associated with worse in-hospital outcomes. Age, anterior myocardial infarction, Syntax score, ventricular arrhythmias, blood glucose level at admission, PCI failure, Killip class III-IV, total ischemia time >180 minutes were the independent predictor of death.

About the Authors

I. S. Bessonov
Tyumen Cardiology Research Center, Tomsk National Research Medical Center of RAS
Russian Federation

Ivan S. Bessonov, candidate of medical sciences 

625026 Tyumen, Melnikaite str., 111



V. A. Kuznetsov
Tyumen Cardiology Research Center, Tomsk National Research Medical Center of RAS
Russian Federation

Vadim A. Kuznetsov, doctor of medical sciences, professor 

625026 Tyumen, Melnikaite str., 111



E. A. Gorbatenko
Tyumen Cardiology Research Center, Tomsk National Research Medical Center of RAS
Russian Federation

Elena A. Gorbatenko 

625026 Tyumen, Melnikaite str., 111



S. S. Sapozhnikov
Tyumen Cardiology Research Center, Tomsk National Research Medical Center of RAS
Russian Federation

Stanislav S. Sapozhnikov 

625026 Tyumen, Melnikaite str., 111



I. P. Zyryanov
Tyumen Cardiology Research Center, Tomsk National Research Medical Center of RAS
Russian Federation

Igor P. Zyryanov, candidate of medical sciences 

625026 Tyumen, Melnikaite str., 111



References

1. Neumann F.J., Sousa-Uva M., Ahlsson A., Alfonso F., Banning A.P., Benedetto U., Byrne R.A., Collet J.P., Falk V., Head S.J., Juni P., Kastrati A., Koller A., Kristensen S.D., Niebauer J., Richter D.J., Seferovic P.M., Sibbing D., Stefanini G.G., Windecker S., Yadav R., Zembala M.O. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur. Heart J. 2019; 40 (2): 87–165. doi:10.1093/eurheartj/ehy394

2. Кузнецов В.А., Ярославская В.И., Пушкарев Г.С., Зырянов И.П., Бессонов И.С., Горбатенко Е.А., Нямцу А.М. Взаимосвязь чрескожных коронарных вмешательств при острых формах ишемической болезни сердца и показателей смертности населения Тюменской области. Рос. кардиол. ж. 2014; 110 (6): 42–46. doi: 10.15829/1560-4071-2014-6-42-46 Kuznetsov V.A., Yaroslavskaya V.I., Pushkarev G.S., Zyryanov I.P., Bessonov I.S., Gorbatenko E.A., Nyamtsu A.M. Interrelation of transcutaneous coronary interventions for acute forms of coronary heart disease and mortality parameters in tyumen region inhabitants. Rossijskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2014; 110 (6): 42–46. [In Russian]. doi: 10.15829/1560-4071-2014-6-42-46

3. Viana-Tejedor A., Loughlin G., FernandezAviles F., Bueno H. Temporal trends in the use of reperfusion therapy and outcomes in elderly patients with first ST elevation myocardial infarction. Eur. Heart J. Acute Cardiovasc. Care. 2015; 4 (5): 461–467. doi:10.1177/2048872614565928

4. Tisminetzky M., Erskine N., Chen H.-Y., Gore J., Gurwitz J., Yarzebski J., Joffe S., Shaw P., Goldberg R. Changing trends in, and сharacteristics associated with, not undergoing cardiac catheterization in elderly adults hospitalized with ST-segment elevation acute myocardial infarction. J. Am. Geriatr. Soc. 2015; 63 (5): 925–931. doi: 10.1111/jgs.13399

5. Haller P.M., Jager B., Farhan S., Christ G., Schreiber W., Weidinger F., Stefenelli T., DelleKarth G., Kaff A., Maurer G., Huber K. Impact of age on short and long-term mortality of patients with STelevation myocardial infarction in the VIENNA STEMI network. Wien Klin. Wochenschr. 2018; 130 (5-6): 172– 181. doi: 10.1007/s00508-017-1250-7

6. Алекян Б.Г., Григорьян А.М., Стаферов А.В. Рентгенэндоваскулярная диагностика и лечение заболеваний сердца и сосудов в Российской Федерации – 2016 год. М.: Ла График, 2017. 220 с. Аlekyan B.G., Grigor’yan А.M., Staferov А.V. X-ray endovascular diagnostics and treatment of heart and vascular diseases in the Russian Federation – 2016 year. Moscow: La Grafik, 2017. 220 p. [In Russian].

7. Барбараш О.Л., Кашталап В.В., Кочергина А.М., Леонова В.О., Эрлих А.Д. Ведение пациентов с острым коронарным синдромом с подъемом сегмента ST в инвазивных стационарах. Результаты регистрового исследования РЕКОРД-3. Фундам. и клин. мед. 2016; 1 (3): 6–13. Barbarash O.L., Kashtalap V.V., Kochergina A.M., Leonova V.O., Erlikh A.D. Management of patients with ST-segment elevation acute coronary syndrome in interventional cardiology units: record-3 registry data. Fundamental’naya i klinicheskaya meditsina = Fundamental and Clinical Medicine. 2016; 1 (3): 6–13. [In Russian].

8. Vasiljevic-Pokrajcic Z., Mickovski N., Davidovic G., Asanin M., Stefanovic B., Krljanac G., Radosavljevic-Radovanovic M., Radovanovic N., Lasica R., Milanovic S., Bjekic J., Majstorovic-Stakic M., Trifunovic D., Karadzic A., Rajic D., Milosevic A., Zdravkovic M., Saric J., Bugiardini R. Sex and age differences and outcomes in acute coronary syndromes. Int. J. Cardiol. 2016; 217 Suppl: 27–31. doi: 10.1016/j.ijcard.2016.06.217

9. Naja S., Makhlouf M.M.E.D., Chehab M.A.H. An ageing world of the 21st century: a literature review. Int. J. Commun. Med. Public Health. 2017; 4 (12): 4363–4369. doi: 10.18203/2394-6040.ijcmph20175306

10. Fach A., Bunger S., Zabrocki R., Schmucker J., Conradi P., Garstka D., Fiehn E., Hambrecht R., Wienbergen H. Comparison of outcomes of patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention analyzed by age groups (<75, 75 to 85, and >85 years); (Results from the Bremen STEMI Registry). Am. J. Cardiol. 2015; 116: 1802–1809. doi: 10.1016/j.amjcard.2015.09.022

11. Peiyuan H., Jingang Y., Haiyan X., Xiaojin G., Ying X., Yuan W., Wei L., Yang W., Xinran T., Ruohua Y., Chen J., Lei S., Xuan Z., Rui F., Yunqing Y., Qiuting D., Hui S., Xinxin Y., Runlin G., Yuejin Y., CAMI Registry study group. The comparison of the outcomes between primary PCI, fibrinolysis, and no reperfusion in patients ≥ 75 years old with ST-segment elevation myocardial infarction: results from the Chinese Acute Myocardial Infarction (CAMI) Registry. PLoS One. 2016; 11 (11): e0165672. doi: 10.1371/journal.pone.0165672

12. Yudi M.B., Jones N., Fernando D., Clark D.J., Ramchand J., Jones E., Dakis R., Johnson D., Chan R., Islam A., Farouque O., Horrigan M. Management of patients aged ≥ 85 years with ST-elevation myocardial infarction. Am. J. Cardiol. 2016; 118 (1): 44–48. doi: 10.1016/j.amjcard.2016.04.010

13. Cenko E., Ricci B., Kedev S., Kalpak O., Calmac L., Vasiljevic Z., Knezevic B., Dilic M., Milicic D., Manfrini O., Koller A., Dorobantu M., Badimon L., Bugiardini R. The no-reflow phenomenon in the young and in the elderly. Int. J. Cardiol. 2016; 222: 1122–1128. doi: 10.1016/j.ijcard.2016.07.209

14. Wang J.W., Zhou Z.Q., Chen Y.D., Wang C.H., Zhu X.L. A risk score for no reflow in patients with STsegment elevation myocardial infarction after primary percutaneous coronary intervention. Clin. Cardiol. 2015; 38 (4): 208–215. doi: 10.1002/clc.22376

15. Nielsen C.G., Laut K.G., Jensen L.O., Ravkilde J., Terkelsen C.J., Kristensen S.D. Patient delay in patients with ST-elevation myocardial infarction: time patterns and predictors for a prolonged delay. Eur. Heart J. Acute Cardiovasc. Care. 2017; 6 (7): 583–591. doi: 10.1177/2048872616676570

16. Brieger D., Eagle K.A., Goodman S.G., Steg P.G., Budaj A., White K., Montalescot G., GRACE Investigators. Acute coronary syndromes without chest pain, an underdiagnosed and undertreated high-risk group: insights from the Global Registry of Acute Coronary Events. Chest. 2004; 126 (2): 461–469. doi: 10.1378/chest.126.2.461

17. Varenne O., Cook S., Sideris G., Ke-dev S., Cuisset T., Carrie D., Hovasse T., Garot P., Mahmoud R.E., Spaulding C., Helft G., Diaz Fernandez J.F., Brugaletta S., Pinar-Bermudez E., Mauri Ferre J., Commeau P., Teiger E., Bogaerts K., Sabate M., Morice M.C., Sinnaeve P.R., SENIOR investigators. Drug-eluting stents in elderly patients with coronary artery disease (SENIOR): a randomized single-blind trial. Lancet. 2018; 391 (10115): 41–50. doi: 10.1016/S0140-6736(17)32713-7

18. Kheiri B., Osman M., Abdalla A., Haykal T., Chahine A., Gwinn M., Ahmed S., Hassan M., Bachuwa G., Bhatt D.L. Drug-eluting versus bare-metal stents in older patients: A metaanalysis of randomized controlled trials. Cardiovasc. Revasc. Med. 2019; 20 (9): 744–751. doi: 10.1016/j.carrev.2018.11.005

19. Cantor W.J., Mehta S.R., Yuan F., Dzavik V., Worthley M., Niemela K., Valentin V., Fung A., Cheema A.N., Widimsky P., Natarajan M. Radial versus femoral access for elderly patients with acute coronary syndrome undergoing coronary angiography and intervention: insights from the RIVAL trial. Am. Heart J. 2015; 170 (5): 880–886. doi: 10.1016/j.ahj.2015.08.011

20. Киреев К.А., Фокин А.А., Киреева Т.С. Снижение госпитальной летальности при инфаркте миокарда в «проблемных группах» – акцент на пациентов старше 75 лет. Комплекс. пробл. серд.- сосуд. заболев. 2017; 6 (1): 71–78. doi: 17802/2306- 1278-2017-1-71-78 Kireev K.A., Fokin A.A., Kireeva T.S. The reduction of hospital mortality of myocardial infarction in «problem groups» – focus on patients over 75 years. Kompleksnye problemy serdechno-sosudistykh zabolevaniy = Complex Issues of Cardiovascular Diseases. 2017; 6 (1): 71–78. [In Russian]. doi: 17802/2306-1278-2017-1-71-78


Review

Views: 327


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2410-2512 (Print)
ISSN 2410-2520 (Online)