Outcomes after STEMI in old multimorbid patients with complex health needs and the effect of invasive management.
Cast your vote
You can rate an item by clicking the amount of stars they wish to award to this item.
When enough users have cast their vote on this item, the average rating will also be shown.
Your vote was cast
Thank you for your feedback
Thank you for your feedback
AuthorsGudnadottir, Gudny Stella
James, Stefan Karl
Thrainsdottir, Inga Sigurros
MetadataShow full item record
CitationOutcomes after STEMI in old multimorbid patients with complex health needs and the effect of invasive management. 2019, 211:11-21 Am Heart J
AbstractThe aim of this study was to assess one-year outcomes of invasive and non-invasive strategies in ST-elevation myocardial infarction (STEMI) among multimorbid older people with complex health needs. We included patients, registered between 2006 and 2013 in the SWEDEHEART registry, who were 70 years old or older with STEMI, had multimorbidity and complex health needs and were discharged alive. The one-year outcomes of patients who underwent invasive strategy (examined with coronary angiography ≤14 days) were compared to those who did not. The primary event was a composite of all-cause death, admission due to new acute coronary syndrome, stroke or transient ischemic attack. We identified patients, and 1089 were managed invasively and 570 non-invasively. The mean age was 79 years and 83 years in the 2 groups, respectively. After multivariable adjustment for baseline differences between the groups, including propensity scores, the primary event occurred in 31% of patients in the invasive group and 55% in the non-invasive group, adjusted hazard ratio (95% confidence intervals): 0.67 (0.54-0.83). One-year mortality was 18% in the invasive group and 45% in the non-invasive group, adjusted hazard ratio 0.51 (0.39-0.65). Multimorbid older people with complex health needs and STEMI had high rates of new ischemic events and death. In this cohort of older, high risk STEMI patients, an invasive strategy was associated with lower event rates. Randomized studies are needed to clarify whether these high risk patients who might benefit from invasive care are being managed too conservatively.
DescriptionTo access publisher's full text version of this article click on the hyperlink below
- Differences in Short- and Long-Term Outcomes Among Older Patients With ST-Elevation Versus Non-ST-Elevation Myocardial Infarction With Angiographically Proven Coronary Artery Disease.
- Authors: Vora AN, Wang TY, Hellkamp AS, Thomas L, Henry TD, Goyal A, Roe MT
- Issue date: 2016 Sep
- Multimorbidity and Readmissions in Older People with Acute Coronary Syndromes.
- Authors: Gudnadottir GS, Gudnason T, Wilhelmson K, Ravn-Fischer A
- Issue date: 2022
- Angiography-guided Multivessel Percutaneous Coronary Intervention Versus Ischemia-guided Percutaneous Coronary Intervention Versus Medical Therapy in the Management of Significant Disease in Non-Infarct-related Arteries in ST-Elevation Myocardial Infarction Patients With Multivessel Coronary Disease.
- Authors: Perera D, Crake T, Lee V
- Issue date: 2018 Jun
- The prognostic utility of GRACE risk score in predictive cardiovascular event rate in STEMI patients with successful fibrinolysis and delay intervention in non PCI-capable hospital: a retrospective cohort study.
- Authors: Chotechuang Y, Phrommintikul A, Muenpa R, Patumanond J, Chaichuen T, Kuanprasert S, Thanachikun N, Benjanuwatra T, Sukonthasarn A
- Issue date: 2016 Nov 8
- Management of Patients Aged ≥85 Years With ST-Elevation Myocardial Infarction.
- Authors: Yudi MB, Jones N, Fernando D, Clark DJ, Ramchand J, Jones E, Dakis R, Johnson D, Chan R, Islam A, Farouque O, Horrigan M
- Issue date: 2016 Jul 1