A retrospective study of an invasive versus conservative strategy in patients aged ≥80 years with acute ST-segment elevation myocardial infarction. Issue 9 (September 2019)

• Record Type: Journal Article
• Authors: Sui, Yong-Gang; Teng, Si-Yong; Qian, Jie; Wu, Yuan; Dou, Ke-Fei; Tang, Yi-Da; Qiao, Shu-Bin; Wu, Yong-Jian
• Is Part Of: Journal of international medical research. Volume 47:Issue 9(2019)
• Page Start: 4431
• Page End: 4441
• Publication Date: 2019-09
• Subjects: ST-segment elevation myocardial infarction -- invasive strategy -- conservative strategy -- older patients -- prognosis; Medicine -- Periodicals; Pharmacology -- Periodicals; 610.5
• DOI: 10.1177/0300060519860969
• Languages: English
• ISSNs: 0300-0605

Abstract

Objective: To investigate what is the most appropriate strategy for patients with ST-segment elevation myocardial infarction (STEMI) aged ≥80 years in China. Methods: This cohort study retrospectively enrolled patients with STEMI aged ≥80 years old and grouped them according to the treatment strategy that was used: a conservative treatment strategy or an invasive treatment strategy. Factors associated with whether to perform an invasive intervention, in-hospital death and a good prognosis were investigated using logistic regression analyses. Results: A total of 232 patients were enrolled: conservative treatment group ( n = 93) and invasive treatment group ( n = 139). Patients in the invasive treatment group had a better prognosis and lower incidence of adverse events compared with the conservative treatment group. Advanced age, creatinine level and a higher Killip class were inversely correlated with whether to perform an invasive intervention, while the use of beta-receptor-blocking agents was a favourable factor for invasive treatment. Hypertension and a higher Killip class were risk factors for in-hospital death, while the use of beta-receptor-blocking agents and diuretics decreased the risk of in-hospital death. Conclusions: An invasive treatment strategy was superior to a conservative treatment strategy in patients with STEMI aged ≥80 years.