[Percutaneous coronary intervention effectiveness in acute coronary syndromes in patients over 80 years
Jozefa Dabek1, Daniel Jakubowski, Zbigniew Gasior
1Slaski Uniwersytet Medyczny w Katowicach, Katedra i Klinika Kardiologii Slaskiego. jdabek@sum.edu.pl
Insights
Percutaneous coronary intervention (PCI) in patients over 80 with acute coronary syndrome improved well-being and quality of life. However, mortality was higher post-hospitalization, particularly in women with ST-elevation myocardial infarction and comorbidities.
Area of Science:
- Cardiology
- Geriatrics
- Interventional Cardiology
Background:
- Atherosclerosis is a progressive inflammatory disease common in the elderly.
- Previous studies analyzed acute coronary syndromes in patients over 80.
- This study extends observations on long-term outcomes of PCI in this demographic.
Purpose of the Study:
- To evaluate the effectiveness of remote monitoring after percutaneous coronary intervention (PCI) in patients aged 80+ with acute coronary syndrome (ACS).
- To assess the impact of PCI on patient well-being and quality of life.
- To identify factors influencing long-term outcomes in elderly ACS patients.
Main Methods:
- A cohort of 31 patients (15 women, 16 men) aged 80-92 underwent PCI with coronary stenting for ACS in 2005.
- Follow-up data was collected to assess survival and quality of life.
- Clinical and biochemical parameters were compared between survivors and non-survivors.
Main Results:
- Of 31 patients, 24 survived the observation period; seven died.
- Deceased patients showed significant differences in clinical and biochemical parameters compared to survivors.
- Higher post-hospitalization mortality was observed in patients with ST-elevation myocardial infarction; women constituted 72% of deaths.
Conclusions:
- A majority of elderly patients reported improved well-being and quality of life after PCI.
- Increased post-hospitalization mortality is linked to ST-elevation myocardial infarction, diabetes, and comorbidities, particularly in women.
- PCI can be beneficial for selected elderly patients, but risk stratification is crucial.
Unlabelled:
Atherosclerosis is a chronic and progressive inflammatory process that causes the most advanced changes in elderly people. In 2006 we published the results of the analysis of acute coronary syndromes in patients after 80 years of age. Conducted the study have decided to extend the observation of distant patients. THE AIM of this study was to assess the effectiveness of remote monitoring percutaneous coronary intervention (PCI) performed in patients with acute coronary syndrome after 80 years of age and to demonstrate the potential benefits of the treatment on the basis of well-being and quality of life of studied patients.
Materials And Methods:
The study included 15 women and 16 men aged from 80 to 92 years, which in 2005 because of acute coronary syndrome (ACS) PCI was performed with stenting of coronary vessels.
Results:
The 31-person group of patients after percutaneous coro-: nary intervention to the end of the observation period 24 patients survived, while seven died. A comparison group of patients living with the deceased showed a number of differences, both clinical as well as the biochemical parameters evaluated. Women accounted for up to 72% among the deceased patients. Moreover, increased posthospitalization mortality in patients with ST elevation myocardial infarction was documented. The majority of patients during the observation period was in class II according to the criteria of the Canadian Society of Cardiology.
Conclusions:
Analysis of the obtained results in the observation of distant percutaneous balloon therapy with stenting of coronary vessels in patients after 80 years of age showed a majority of respondents declared by the benefit of the treatment administered in the form of improved well-being and quality of life. The analysis of deaths during follow-up period showed the increased mortality during posthospitalization period in patients with ST elevation myocardial infarction and documented the predominance of patients with diabetes and other co-morbidities, especially in women.
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