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Fernández-Bergés D, Degano IR, Gonzalez Fernandez R, Subirana I, Vila J, Jiménez-Navarro M, Perez-Fernandez S, Roqué M, Bayes-Genis A, Fernandez-Aviles F, Mayorga A, Bertomeu-Gonzalez V, Sanchis J, Rodríguez Esteban M, Sanchez-Hidalgo A, Sanchez-Insa E, Elorriaga A, Abu Assi E, Nuñez A, Garcia Ruiz JM, Morrondo Valdeolmillos P, Bosch-Portell D, Lekuona I, Carrillo-Lopez A, Zamora A, Vega-Hernandez B, Alameda Serrano J, Rubert C, Ruiz-Valdepeñas L, Quintas L, Rodríguez-Padial L, Vaquero J, Martinez Dolz L, Barrabes JA, Sanchez PL, Sionis A, Martí-Almor J, Elosua R, Lidon RM, Garcia-Dorado D, Marrugat J. Benefit of primary percutaneous coronary interventions in the elderly with ST segment elevation myocardial infarction. Open Heart 2020; 7:openhrt-2019-001169. [PMID: 32747454 PMCID: PMC7402007 DOI: 10.1136/openhrt-2019-001169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 04/21/2020] [Accepted: 06/02/2020] [Indexed: 02/01/2023] Open
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 ATención HOspitalaria del Síndrome 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.
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Affiliation(s)
- Daniel Fernández-Bergés
- Unidad de Investigación, Hospital Don Benito-Villanueva, Don Benito, Spain .,Instituto Universitario de Investigación Biosanitaria de Extremadura, Badajoz, Spain
| | - Irene R Degano
- Institut Hospital del Mar d' Investigacions Mediques, Barcelona, Spain
| | | | - Isaac Subirana
- Institut Hospital del Mar d' Investigacions Mediques, Barcelona, Spain.,CIBERESP de Epidemiologia y Salud Publica, Barcelona, Spain
| | - Joan Vila
- Institut Hospital del Mar d' Investigacions Mediques, Barcelona, Spain.,CIBERESP de Epidemiologia y Salud Publica, Barcelona, Spain
| | | | - Silvia Perez-Fernandez
- CIBER Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain.,Institut Hospital del Mar d'Investigacions Mediques, Barcelona, Spain
| | | | - Antoni Bayes-Genis
- Department of Cardiology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | | | - Antonio Mayorga
- Department of Cardiology, Hospital Universitario Gregorio Marañón, Madrid, Madrid, Spain
| | | | - Juan Sanchis
- Cardiology Department, Hospital Clinico Universitario, INCLIVA, Universitat de València, Valencia, Spain
| | - Marcos Rodríguez Esteban
- Department of Cardiology, Hospital Universitario Nuestra Senora de la Candelaria, Santa Cruz de Tenerife, Spain
| | | | - Esther Sanchez-Insa
- Department of Cardiology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Ane Elorriaga
- Department of Cardiology, Hospital Universitario de Basurto, Bilbao, Bilbao, Spain
| | - Emad Abu Assi
- Department of Cardiology, Hospital Álvaro Junqueiro de Vigo, Pontevedra, Vigo, Spain
| | - Alberto Nuñez
- Department of Cardiology, Hospital Universitario Fundación de Alcorcón, Madrid, Spain
| | | | | | - Daniel Bosch-Portell
- Department of Cardiology, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
| | - Iñaki Lekuona
- Department of Cardiology, Hospital Galdakao-Usansolo, Galdacano, Spain
| | | | | | | | | | | | | | | | | | - Jessica Vaquero
- Hospital Universitario Araba sede Txagorritxu, Vitoria-Gasteiz, Spain
| | | | - Jose A Barrabes
- Department of Cardiology, University Hospital Vall d'Hebron, Barcelona, Spain
| | - Pedro L Sanchez
- Department of Cardiology, Hospital Universitario Salamanca, Salamanca, Spain
| | - Alessandro Sionis
- Intensive Cardiac Care Unit, Cardiology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute IIB-Sant Pau, Universitat de Barcelona, Barcelona, Spain
| | - Julio Martí-Almor
- Department of Medicine, Department of Cardiology, Hospital del Mar. Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Roberto Elosua
- Institut Hospital del Mar d' Investigacions Mediques, Barcelona, Spain.,CIBER Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain.,Universitat de Vic, Barcelona, Spain
| | | | | | - Jaume Marrugat
- Institut Hospital del Mar d' Investigacions Mediques, Barcelona, Spain.,CIBER Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain
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