| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Amann, Ute Kirchberger, Inge Heier, Margit Thilo, Christian Kuch, Bernhard Peters, Annette Meisinger, Christa |
| Abstract | Background A substantial proportion of patients with acute myocardial infarction (AMI) did not receive invasive therapy, defined as percutaneous coronary intervention and/or coronary artery bypass grafting. Aims of this study were to evaluate predictors of non-invasive therapy in elderly compared to younger AMI patients and to assess the association between invasive therapy and 28-day-case fatality. Methods From the German population-based registry, 3475 persons, consecutively hospitalized with an AMI between 2009 and 2012 were included. Data were collected by standardized interviews and chart review. All-cause mortality was assessed on a regular basis. Multivariable logistic regression analyses were conducted. Results The sample consisted of 1329 patients aged 28–65 years (age category [AC] 1), 1083 aged 65–74 years (AC 2), and 1063 aged 75–84 years (AC 3). The proportion of patients receiving non-invasive therapy was 10.7, 17.7, and 35.8 % in AC 1, 2, and 3, respectively. Predictors of non-invasive therapy in all ACs were non-ST segment elevation MI, bundle branch block, reduced left ventricular ejection fraction, prior stroke, absence of hyperlipidemia, and low creatine kinase. Elderly women (≥65 years) were less likely to receive invasive therapy. Stratifying the models by type of AMI revealed fewer predictors in patients with ST segment elevation MI. Regarding 28-day-case fatality, strong inverse relations with invasive therapy were seen in all AC: odds ratio of 0.35 (95 % confidence interval [CI] 0.15–0.84), 0.45 (95 % CI 0.22–0.92), and 0.39 (95 % CI 0.24–0.63) in AC 1, 2 and 3, respectively. Conclusion In today’s real-life patient care we found that predictors of non-invasive therapy were predominantly the same in all age groups, but differed particularly by type of AMI. Further research is necessary to investigate the real reasons for non-invasive therapy, especially among elderly women. Moreover, we confirmed that receiving invasive therapy was inversely associated with 28-day-case fatality independent of age. |
| Related Links | https://bmccardiovascdisord.biomedcentral.com/counter/pdf/10.1186/s12872-016-0322-3.pdf |
| Ending Page | 10 |
| Page Count | 10 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 14712261 |
| DOI | 10.1186/s12872-016-0322-3 |
| Journal | BMC Cardiovascular Disorders |
| Issue Number | 1 |
| Volume Number | 16 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2016-07-13 |
| Access Restriction | Open |
| Subject Keyword | Cardiology Cardiac Surgery Angiology Blood Transfusion Medicine Internal Medicine Medicine Public Health Myocardial infarction Mortality Invasive therapy Predictors Medicine/Public Health |
| Content Type | Text |
| Resource Type | Article |
| Subject | Cardiology and Cardiovascular Medicine |
| Journal Impact Factor | 2/2023 |
| 5-Year Journal Impact Factor | 2.3/2023 |
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