Myocardial Infarction in Centenarians. Data from The Polish Registry of Acute Coronary Syndromes
Background: There are no data regarding the mortality rate, risks and benefits of particular reperfusion methods and pharmacological treatment complications in patients aged over 100 years with acute coronary syndromes. We sought to assess the treatment of myocardial infarction (MI) in patients olde...
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MDPI AG
2020-10-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/10/3377 |
| _version_ | 1797550245382455296 |
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| author | Jacek Piegza Lech Poloński Aneta Desperak Andrzej Wester Marianna Janion Wiesław Mazurek Wojciech Wojakowski Adam Witkowski Dariusz Dudek Mariusz Gąsior |
| author_facet | Jacek Piegza Lech Poloński Aneta Desperak Andrzej Wester Marianna Janion Wiesław Mazurek Wojciech Wojakowski Adam Witkowski Dariusz Dudek Mariusz Gąsior |
| author_sort | Jacek Piegza |
| collection | DOAJ |
| description | Background: There are no data regarding the mortality rate, risks and benefits of particular reperfusion methods and pharmacological treatment complications in patients aged over 100 years with acute coronary syndromes. We sought to assess the treatment of myocardial infarction (MI) in patients older than 100 years and to determine prognostic factors for this group. Methods: Among the 716,566 patients recorded between 2003 and 2018 in the Polish Registry of Acute Coronary Syndromes, 104 patients aged ≥100 with MI were included. The patients were categorized into two groups: group 1 received conservative treatment (64 patients), and group 2 received invasive strategy (40 patients). Results: The frequencies of in-hospital mortality, MI and stroke were similar in both arms. No difference in the frequency of the combined endpoint (death, reinfarction, stroke) was noted. Invasive treatment was more advantageous for 12-month outcomes; 50 patients in group 1 (79%) and 23 patients in group 2 (57.50%) died (<i>p</i> = 0.017). The multivariate analysis identified the lower left ventricular ejection fraction (EF) (Hazard Ratio (HR) = 0.96; 95% Confidence Interval (CI): 0.94–0.99; <i>p</i> = 0.012), lack of coronary angiography (HR = 0.49; 95% CI: 0.24–0.99; <i>p</i> = 0.048) and cardiac arrest (HR = 4.61; 95% CI: 1.64–12.99; <i>p</i> = 0.0038) as predictors of 12-month mortality in this group. Conclusions: Invasive MI treatment may be beneficial for selected very old patients. |
| first_indexed | 2024-03-10T15:26:39Z |
| format | Article |
| id | doaj.art-827486c8e61d473e8b1877d305746496 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T15:26:39Z |
| publishDate | 2020-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-827486c8e61d473e8b1877d3057464962023-11-20T18:00:08ZengMDPI AGJournal of Clinical Medicine2077-03832020-10-01910337710.3390/jcm9103377Myocardial Infarction in Centenarians. Data from The Polish Registry of Acute Coronary SyndromesJacek Piegza0Lech Poloński1Aneta Desperak2Andrzej Wester3Marianna Janion4Wiesław Mazurek5Wojciech Wojakowski6Adam Witkowski7Dariusz Dudek8Mariusz Gąsior9Third Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, PolandThird Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, PolandThird Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, PolandDepartment of Physiology, Institute of Medical Sciences, University of Opole, 45-040 Opole, PolandCollegium Medicum, Jan Kochanowski University, 25-369 Kielce, PolandDepartment of Cardiology, The Ludwik Rydygier Provincial Polyclinical Hospital, 87-100 Torun, Poland3rd Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Faculty of Medical Sciences in Katowice, 40-055 Katowice, PolandDepartment of Interventional Cardiology and Angiology, National Institute of Cardiology, 04-628 Warsaw, PolandDepartment of Interventional Cardiology, Jagiellonian University, 31-007 Krakow, PolandThird Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, PolandBackground: There are no data regarding the mortality rate, risks and benefits of particular reperfusion methods and pharmacological treatment complications in patients aged over 100 years with acute coronary syndromes. We sought to assess the treatment of myocardial infarction (MI) in patients older than 100 years and to determine prognostic factors for this group. Methods: Among the 716,566 patients recorded between 2003 and 2018 in the Polish Registry of Acute Coronary Syndromes, 104 patients aged ≥100 with MI were included. The patients were categorized into two groups: group 1 received conservative treatment (64 patients), and group 2 received invasive strategy (40 patients). Results: The frequencies of in-hospital mortality, MI and stroke were similar in both arms. No difference in the frequency of the combined endpoint (death, reinfarction, stroke) was noted. Invasive treatment was more advantageous for 12-month outcomes; 50 patients in group 1 (79%) and 23 patients in group 2 (57.50%) died (<i>p</i> = 0.017). The multivariate analysis identified the lower left ventricular ejection fraction (EF) (Hazard Ratio (HR) = 0.96; 95% Confidence Interval (CI): 0.94–0.99; <i>p</i> = 0.012), lack of coronary angiography (HR = 0.49; 95% CI: 0.24–0.99; <i>p</i> = 0.048) and cardiac arrest (HR = 4.61; 95% CI: 1.64–12.99; <i>p</i> = 0.0038) as predictors of 12-month mortality in this group. Conclusions: Invasive MI treatment may be beneficial for selected very old patients.https://www.mdpi.com/2077-0383/9/10/3377myocardial infarctionelderlycentenarianspercutaneous coronary intervention |
| spellingShingle | Jacek Piegza Lech Poloński Aneta Desperak Andrzej Wester Marianna Janion Wiesław Mazurek Wojciech Wojakowski Adam Witkowski Dariusz Dudek Mariusz Gąsior Myocardial Infarction in Centenarians. Data from The Polish Registry of Acute Coronary Syndromes Journal of Clinical Medicine myocardial infarction elderly centenarians percutaneous coronary intervention |
| title | Myocardial Infarction in Centenarians. Data from The Polish Registry of Acute Coronary Syndromes |
| title_full | Myocardial Infarction in Centenarians. Data from The Polish Registry of Acute Coronary Syndromes |
| title_fullStr | Myocardial Infarction in Centenarians. Data from The Polish Registry of Acute Coronary Syndromes |
| title_full_unstemmed | Myocardial Infarction in Centenarians. Data from The Polish Registry of Acute Coronary Syndromes |
| title_short | Myocardial Infarction in Centenarians. Data from The Polish Registry of Acute Coronary Syndromes |
| title_sort | myocardial infarction in centenarians data from the polish registry of acute coronary syndromes |
| topic | myocardial infarction elderly centenarians percutaneous coronary intervention |
| url | https://www.mdpi.com/2077-0383/9/10/3377 |
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