Clinical characteristic and management of elderly patients with myocardial infarction
Introduction/Objective. Population of elderly people is increasing and modern medicine is faced with the problem of large morbidity and mortality from cardiovascular diseases in this age group. Modern treatment strategies have not been sufficiently investigated in the elderly, therefore these people...
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| Format: | Article |
| Language: | English |
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Serbian Medical Society
2019-01-01
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| Series: | Srpski Arhiv za Celokupno Lekarstvo |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0370-8179/2019/0370-81791900011D.pdf |
| _version_ | 1819295340699844608 |
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| author | Dejanović Jadranka Ivanov Igor Popov Tanja Čanković Milenko Vulin Aleksandra Obradović Dušanka Ivanović Vladimir Stojšić-Milosavljević Anastazija |
| author_facet | Dejanović Jadranka Ivanov Igor Popov Tanja Čanković Milenko Vulin Aleksandra Obradović Dušanka Ivanović Vladimir Stojšić-Milosavljević Anastazija |
| author_sort | Dejanović Jadranka |
| collection | DOAJ |
| description | Introduction/Objective. Population of elderly people is increasing and modern medicine is faced with the problem of large morbidity and mortality from cardiovascular diseases in this age group. Modern treatment strategies have not been sufficiently investigated in the elderly, therefore these people often receive suboptimal treatment. The aim of the study was to evaluate clinical characteristic, cardiac risk factors, management strategies and early outcome in the elderly patient with ST elevated myocardial infarction (STEMI). Methods. This retrospective study included 217 consecutive patients, aged ≥ 70 years (mean age 77.6 ± 4.9 years, 103 men, 114 women) with STEMI admitted to the Institute of Cardiovascular Diseases of Vojvodina. We have analyzed patients’ clinical characteristics, risk factors, left ventricular function and treatment strategies in relation to in-hospital outcome. Results. First clinical symptom was chest pain in 209 (96.3%) of patients. On admission, 35 (16.1%) patients were with severe signs of heart failure (Killip class III–IV). Duration of symptom onset to hospital admission was 14.7 ± 28.6 hours. Out of 217 patients, 168 (77.4%) patients received reperfusion treatment, including primary percutaneous coronary ntervention (PPCI) in 164 (75.6%) patients, and fibrinolytic therapy in 4 (1.8%) patients. Hospital mortality was 26.3% (57 patients). PPCI was univariate predictor of lower in-hospital mortality, whereas multivariate predictors of in-hospital mortality were cardiogenic shock (OR 67.095; 95% CI (6.845–657.646); p < 0.001) and low ejection fraction (OR 0.901; 95% CI (0.853–0.963); p = 0.001). Conclusion. In elederly patients presenting with STEMI, PPCI was asscoiated with lower mortality, whereas cardiogenic shock and lower ejection fraction were independent predictors of worse prognosis after STEMI. |
| first_indexed | 2024-12-24T04:40:40Z |
| format | Article |
| id | doaj.art-f47816b12a0b4f289836f5fc69a06604 |
| institution | Directory Open Access Journal |
| issn | 0370-8179 |
| language | English |
| last_indexed | 2024-12-24T04:40:40Z |
| publishDate | 2019-01-01 |
| publisher | Serbian Medical Society |
| record_format | Article |
| series | Srpski Arhiv za Celokupno Lekarstvo |
| spelling | doaj.art-f47816b12a0b4f289836f5fc69a066042022-12-21T17:14:50ZengSerbian Medical SocietySrpski Arhiv za Celokupno Lekarstvo0370-81792019-01-011473-416717210.2298/SARH171016011D0370-81791900011DClinical characteristic and management of elderly patients with myocardial infarctionDejanović Jadranka0Ivanov Igor1Popov Tanja2Čanković Milenko3Vulin Aleksandra4Obradović Dušanka5Ivanović Vladimir6Stojšić-Milosavljević Anastazija7Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica + Faculty of Medicine, Novi SadInstitute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica + Faculty of Medicine, Novi SadInstitute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica + Faculty of Medicine, Novi SadInstitute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica + Faculty of Medicine, Novi SadInstitute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica + Faculty of Medicine, Novi SadFaculty of Medicine, Novi Sad + Institute of Pulmonary Diseases of Vojvodina, Sremska KamenicaInstitute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica + Faculty of Medicine, Novi SadInstitute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica + Faculty of Medicine, Novi SadIntroduction/Objective. Population of elderly people is increasing and modern medicine is faced with the problem of large morbidity and mortality from cardiovascular diseases in this age group. Modern treatment strategies have not been sufficiently investigated in the elderly, therefore these people often receive suboptimal treatment. The aim of the study was to evaluate clinical characteristic, cardiac risk factors, management strategies and early outcome in the elderly patient with ST elevated myocardial infarction (STEMI). Methods. This retrospective study included 217 consecutive patients, aged ≥ 70 years (mean age 77.6 ± 4.9 years, 103 men, 114 women) with STEMI admitted to the Institute of Cardiovascular Diseases of Vojvodina. We have analyzed patients’ clinical characteristics, risk factors, left ventricular function and treatment strategies in relation to in-hospital outcome. Results. First clinical symptom was chest pain in 209 (96.3%) of patients. On admission, 35 (16.1%) patients were with severe signs of heart failure (Killip class III–IV). Duration of symptom onset to hospital admission was 14.7 ± 28.6 hours. Out of 217 patients, 168 (77.4%) patients received reperfusion treatment, including primary percutaneous coronary ntervention (PPCI) in 164 (75.6%) patients, and fibrinolytic therapy in 4 (1.8%) patients. Hospital mortality was 26.3% (57 patients). PPCI was univariate predictor of lower in-hospital mortality, whereas multivariate predictors of in-hospital mortality were cardiogenic shock (OR 67.095; 95% CI (6.845–657.646); p < 0.001) and low ejection fraction (OR 0.901; 95% CI (0.853–0.963); p = 0.001). Conclusion. In elederly patients presenting with STEMI, PPCI was asscoiated with lower mortality, whereas cardiogenic shock and lower ejection fraction were independent predictors of worse prognosis after STEMI.http://www.doiserbia.nb.rs/img/doi/0370-8179/2019/0370-81791900011D.pdfST elevated myocardial infarctionprimary percutaneous coronary interventionfibrinolysiselderly |
| spellingShingle | Dejanović Jadranka Ivanov Igor Popov Tanja Čanković Milenko Vulin Aleksandra Obradović Dušanka Ivanović Vladimir Stojšić-Milosavljević Anastazija Clinical characteristic and management of elderly patients with myocardial infarction Srpski Arhiv za Celokupno Lekarstvo ST elevated myocardial infarction primary percutaneous coronary intervention fibrinolysis elderly |
| title | Clinical characteristic and management of elderly patients with myocardial infarction |
| title_full | Clinical characteristic and management of elderly patients with myocardial infarction |
| title_fullStr | Clinical characteristic and management of elderly patients with myocardial infarction |
| title_full_unstemmed | Clinical characteristic and management of elderly patients with myocardial infarction |
| title_short | Clinical characteristic and management of elderly patients with myocardial infarction |
| title_sort | clinical characteristic and management of elderly patients with myocardial infarction |
| topic | ST elevated myocardial infarction primary percutaneous coronary intervention fibrinolysis elderly |
| url | http://www.doiserbia.nb.rs/img/doi/0370-8179/2019/0370-81791900011D.pdf |
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