RESUMEN
OBJECTIVE: Primary percutaneous coronary intervention (P-PCI) has demonstrated its efficacy in patients with ST segment elevation myocardial infarction (STEMI). However, patients with STEMI ≥75 years receive less P-PCI than younger patients despite their higher in-hospital morbimortality. The objective of this analysis was to determine the effectiveness of P-PCI in patients with STEMI ≥75 years. METHODS: We included 979 patients with STEMI ≥75 years, from the ATención HOspitalaria del Síndrome coronario study, a registry of 8142 consecutive patients with acute coronary syndrome admitted at 31 Spanish hospitals in 2014-2016. We calculated a propensity score (PS) for the indication of P-PCI. Patients that received or not P-PCI were matched by PS. Using logistic regression, we compared the effectiveness of performing P-PCI versus non-performance for the composite primary event, which included death, reinfarction, acute pulmonary oedema or cardiogenic shock during hospitalisation. RESULTS: Of the included patients, 81.5 % received P-PCI. The matching provided two groups of 169 patients with and without P-PCI. Compared with its non-performance, P-PCI presented a composite event OR adjusted by PS of 0.55 (95% CI 0.34 to 0.89). CONCLUSIONS: Receiving a P-PCI was significantly associated with a reduced risk of major intrahospital complications in patients with STEMI aged 75 years or older.
Asunto(s)
Intervención Coronaria Percutánea , Infarto del Miocardio con Elevación del ST/terapia , Factores de Edad , Anciano , Anciano de 80 o más Años , Comorbilidad , Femenino , Humanos , Masculino , Intervención Coronaria Percutánea/efectos adversos , Intervención Coronaria Percutánea/mortalidad , Edema Pulmonar/mortalidad , Edema Pulmonar/prevención & control , Recurrencia , Sistema de Registros , Medición de Riesgo , Factores de Riesgo , Infarto del Miocardio con Elevación del ST/diagnóstico por imagen , Infarto del Miocardio con Elevación del ST/mortalidad , Choque Cardiogénico/mortalidad , Choque Cardiogénico/prevención & control , España , Factores de Tiempo , Resultado del TratamientoRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Sarcoma Sinovial/diagnóstico por imagen , Neoplasias Cardíacas/diagnóstico por imagen , Pericardio/patología , Pericardio/diagnóstico por imagenAsunto(s)
Neoplasias Cardíacas/diagnóstico , Imagen Multimodal/métodos , Sarcoma Sinovial/diagnóstico , Terapia Combinada , Diagnóstico Diferencial , Neoplasias Cardíacas/terapia , Humanos , Imagen por Resonancia Cinemagnética , Masculino , Persona de Mediana Edad , Pericardio , Tomografía Computarizada por Tomografía de Emisión de Positrones , Sarcoma Sinovial/terapiaRESUMEN
No disponible
Asunto(s)
Humanos , Aspirina/efectos adversos , Desensibilización Inmunológica/métodos , Isquemia Miocárdica/prevención & control , Hipersensibilidad a las Drogas/terapia , Síndrome Coronario Agudo/complicacionesRESUMEN
No disponible