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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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[ST elevation myocardial infarction (STEMI) in patients aged 85 and over. Invasive management versus exclusive

T Doizon1, L Orion1, J Dimet2

  • 1Service de cardiologie, CHD de Vendée, Les Oudairies, 85000 La Roche-sur-Yon, France.

Annales De Cardiologie Et D'Angeiologie
|October 21, 2015
PubMed

Insights

Invasive management for ST elevation myocardial infarction (STEMI) in elderly patients (85+) may reduce mortality without increasing complications. This study compared invasive reperfusion versus non-invasive treatment in this high-risk population.

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Interventional Cardiology

Background:

  • ST elevation myocardial infarction (STEMI) poses significant risks for elderly patients.
  • The role of invasive management, such as percutaneous coronary intervention (PCI), in this population remains debated.

Purpose of the Study:

  • To evaluate the efficacy and safety of invasive management versus non-invasive treatment for STEMI in patients aged 85 and over.
  • To compare mortality, morbidity, complications, and loss of independence between the two management strategies.

Main Methods:

  • Retrospective single-center study of 118 patients (≥85 years) with STEMI from 2008-2013.
  • Patients were divided into invasive (coronary angiogram/fibrinolysis) and non-invasive (exclusive medical treatment) groups.
  • Outcomes assessed included mortality, intrahospital complications, and loss of independence.

Main Results:

  • The non-invasive group had a higher all-cause mortality rate (45% vs. 28%, P=0.077).
  • No significant differences were observed in intrahospital complication rates or loss of independence between groups.
  • Advanced age, female gender, history of valvular disease, and delayed primary care were identified as negative prognostic factors.

Conclusions:

  • Invasive management of STEMI in elderly patients (≥85 years) appears to reduce one-year mortality.
  • This approach does not seem to increase morbidity or loss of independence compared to non-invasive treatment.
Abstract

Keywords:
Elderly patientsMyocardial revascularizationReperfusion myocardiqueST elevation myocardial infarctionSujets âgésSyndrome coronarien aigu ST+Vendée

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