Predictors of the early outcome in elderly patients with ST elevation myocardial infarction treated with primary angioplasty: A single center experience

Chiara Lazzeri, Serafina Valente, Marco Chiostri, Claudio Picariello, Gian Franco Gensini

Research output: Contribution to journalArticle

Abstract

Elderly patients are under-represented in trials assessing strategies of early coronary revascularization in acute myocardial infarction, though they are the fastest growing segment of our population. The aims of the present investigation, performed in 357 elderly (≥75 years) patients with ST elevation myocardial infarction (STEMI) submitted to primary percutaneous coronary intervention (PCI) consecutively admitted to our Intensive Cardiac Care Unit (ICCU) from 1 January 2006 to 31 December 2009, were as follows: (a) to identify predictors for in-ICCU mortality among clinical, angiographic and metabolic factors and (b) to evaluate whether there are gender-related differences in management, outcome and in the metabolic and inflammatory responses to acute myocardial ischemia. At multivariable backward stepwise logistic regression analysis, the following variables were independent predictors for in-ICCU mortality in the overall population: age (OR 1.15; 95% CI 1.05-1.27; p <0.003), admission glycemia (OR 2.24; 95% CI 1.41-3.56; p <0.001), left ventricular ejection fraction (LVEF) (OR 0.92; 95% CI 0.88-0.97; p <0.001), primary PCI failure (OR 4.70; 95% CI 1.70-12.98; p <0.003). In elderly STEMI patients submitted to primary PCI, early mortality can be related to age, hemodynamic derangement (as indicated by LVEF), the rate of procedural success, and increased glucose values. No gender-related differences in management were detectable in our series. Our data strongly suggest that, in elderly patients in the acute phase of STEMI, since hyperglycemia is a modifying factor, glucose values deserve a more intensive treatment. Further studies, performed specifically in elderly STEMI patients, should be addressed to identify the glucose cut-off values able to influence the outcome.

Original languageEnglish
Pages (from-to)41-46
Number of pages6
JournalInternal and Emergency Medicine
Volume6
Issue number1
DOIs
Publication statusPublished - Feb 2011

Fingerprint

Angioplasty
Percutaneous Coronary Intervention
Intensive Care Units
Glucose
Stroke Volume
Mortality
Hyperglycemia
Population
Myocardial Ischemia
Logistic Models
Hemodynamics
Myocardial Infarction
Regression Analysis
ST Elevation Myocardial Infarction
Therapeutics

Keywords

  • Early mortality
  • Elderly
  • Gender
  • Hyperglycemia
  • PCI
  • ST elevation myocardial infarction

ASJC Scopus subject areas

  • Emergency Medicine
  • Internal Medicine

Cite this

Predictors of the early outcome in elderly patients with ST elevation myocardial infarction treated with primary angioplasty : A single center experience. / Lazzeri, Chiara; Valente, Serafina; Chiostri, Marco; Picariello, Claudio; Gensini, Gian Franco.

In: Internal and Emergency Medicine, Vol. 6, No. 1, 02.2011, p. 41-46.

Research output: Contribution to journalArticle

Lazzeri, Chiara ; Valente, Serafina ; Chiostri, Marco ; Picariello, Claudio ; Gensini, Gian Franco. / Predictors of the early outcome in elderly patients with ST elevation myocardial infarction treated with primary angioplasty : A single center experience. In: Internal and Emergency Medicine. 2011 ; Vol. 6, No. 1. pp. 41-46.
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