These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Effect of an invasive strategy on in-hospital outcome in elderly patients with non-ST-elevation myocardial infarction.
    Author: Bauer T, Koeth O, Jünger C, Heer T, Wienbergen H, Gitt A, Zahn R, Senges J, Zeymer U, Acute Coronary Syndromes Registry (ACOS) Investigators.
    Journal: Eur Heart J; 2007 Dec; 28(23):2873-8. PubMed ID: 17982163.
    Abstract:
    AIMS: We sought to investigate the impact of an invasive treatment in elderly patients presenting with non-ST elevation myocardial infarction (NSTEMI) in clinical practice. METHODS AND RESULTS: We analysed data of consecutive elderly patients (> or =75 years) with NSTEMI who were prospectively enrolled in the German Acute Coronary Syndromes registry between July 2000 and November 2002. Overall 1936 patients were divided into two groups: 1005 (51.9%) underwent coronary angiography and/or revascularization, 931 (48.1%) received conservative treatment. In the invasive group, percutaneous coronary intervention was performed in 37.5% within 48 h and in 17.6% after 48 h, whereas 9.8% underwent coronary artery bypass grafting within the hospital stay. In-hospital death (12.5 vs. 6.0%, P < 0.0001) and death/myocardial infarction (17.3 vs. 9.6%, P < 0.0001) occurred significantly less often in patients with invasive strategy. After adjustment of the confounding factors in the propensity score analysis the invasive strategy remained superior for mortality (OR 0.55, 95% CI 0.35-0.86) and death and non-fatal myocardial infarction (OR 0.51, 95% CI 0.35-0.75) and 1 year mortality (OR 0.56, 95% CI 0.38-0.81). Major bleeding complications tended to be more frequent in the invasive group (8.8 vs. 5.8%, P = 0.07). CONCLUSION: In clinical practice, in elderly patients with NSTEMI, an invasive strategy is associated with an improved in-hospital and 1 year outcome but a trend towards more bleeding complications.
    [Abstract] [Full Text] [Related] [New Search]