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Old Age and Myocardial Injury in ST-Segment Elevation Myocardial Infarction
Ik Hyun Park1, Hyun Kyu Cho1, Ju Hyeon Oh1
1Division of Cardiology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.
Insights
Older age is linked to increased myocardial injury in ST-segment elevation myocardial infarction (STEMI) patients. Even with treatment, advanced age significantly worsens heart damage after STEMI.
Area of Science:
- Cardiology
- Geriatric Medicine
- Medical Imaging
Background:
- The relationship between advanced age and myocardial injury in ST-segment elevation myocardial infarction (STEMI) patients is not well understood.
- Causality and pathological mechanisms require further investigation.
Purpose of the Study:
- To investigate the association between old age and myocardial injury in STEMI patients undergoing primary percutaneous coronary intervention (PCI).
- To quantify myocardial infarct size using cardiovascular magnetic resonance imaging (CMR).
Main Methods:
- A cohort of 279 STEMI patients who underwent primary PCI and CMR were analyzed.
- Patients were divided into two groups: Age ≥70 (n=52) and Age <70 (n=227).
- Inverse probability of treatment weighting was used to adjust for potential confounders.
Main Results:
- Myocardial infarct size on CMR analysis tended to be greater in the Age ≥70 group (21.2% ± 10.2%) versus the Age <70 group (19.5% ± 11.1%), p=0.072.
- After inverse probability of treatment weighting adjustment, myocardial infarct size was significantly greater in the Age ≥70 group (22.6% ± 10.4%) compared to the Age <70 group (19.6% ± 11.1%), p=0.001.
- No significant difference in infarct size was observed between sexes in patients older than 70 years.
Conclusions:
- Old age is independently associated with a greater extent of myocardial injury in STEMI patients.
- This association persists despite appropriate coronary revascularization.
- Age is a critical factor influencing myocardial damage post-STEMI.
Background:
Little is known about the causality and pathological mechanism underlying the association between old age and myocardial injury in patients with ST-segment elevation myocardial infarction (STEMI). We evaluated the association between old age and myocardial injury in STEMI patients undergoing primary percutaneous coronary intervention (PCI) using cardiovascular magnetic resonance imaging (CMR).
Methods:
A total of 279 patients with STEMI who underwent primary PCI and CMR were enrolled. Of these, 52 patients were over the age of 70 years (18.6%, Age ≥70 group) and 227 patients were under the age of 70 years (81.4%, Age <70 group) at STEMI occurrence. We compared myocardial infarct size on CMR according to age at STEMI occurrence and performed inverse probability of treatment weighting.
Results:
On CMR analysis, myocardial infarct size on CMR tended to be greater in the Age ≥70 group than in the Age <70 group (21.2 ± 10.2% versus 19.5 ± 11.1%; p = 0.072). After performing inverse probability of treatment weighting adjustment, myocardial infarct size was significantly greater in the Age ≥70 group compared with the Age <70 group (22.6 ± 10.4% versus 19.6 ± 11.1%; p = 0.001). Subgroup analysis of patients older than 70 years revealed no significant difference in myocardial infarct size according to sex (20.1 ± 11.5% in females versus 20.4 ± 9.9% in males; p = 0.901).
Conclusions:
Despite appropriate coronary revascularization, old age was associated with greater extent of myocardial injury in STEMI patients.
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