Invasive versus Conservative Treatment Approach among Older Adult Patients Admitted with Acute ST-Segment Elevation Myocardial Infarction

Keren-Lee Rozenfeld; Lior Lupu; Ilan Merdler; Samuel Morgan; Shmuel Banai; Yacov Shacham

doi:10.4235/agmr.22.0079

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저자정보: Keren-Lee Rozenfeld (Department of Cardiology Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine Tel Aviv) Lior Lupu (Department of Cardiology Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine Tel Aviv) Ilan Merdler (Department of Cardiology Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine Tel Aviv) Samuel Morgan (Department of Cardiology Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine Tel Aviv) Shmuel Banai (Department of Cardiology Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine Tel Aviv) Yacov Shacham (Department of Cardiology Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine Tel Aviv)

저널정보: 대한노인병학회 Annals of geriatric medicine and research Annals of geriatric medicine and research Vol.26 No.4

발행연도: 2022.12

수록면: 347 - 353 (7page)

DOI: 10.4235/agmr.22.0079

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Background: Primary percutaneous coronary intervention (PCI) is the preferred treatment strategy for patients with ST-elevation myocardial infarction (STEMI); however, its efficacy remains unclear in very older adult patients with STEMI. Methods: This retrospective single-center observational study included 530 patients aged >75 years admitted to Tel Aviv Sourasky Medical Center with a diagnosis of acute STEMI. Primary PCI was performed for patients with symptoms ≤12 hours in duration, while the other patients were conservatively treated. We evaluated 30-day mortality and complications occurring during hospitalization based on data from patient records. Results: Among the study patients, only 28/530 (5%) were conservatively treated. In-hospital complications, including the use of inotropes or intra-aortic balloon counterpulsation and the need for mechanical ventilation, did not differ significantly between the groups. The only parameter that showed a trend toward significance was the incidence of heart failure during hospitalization (p=0.042). The risk for 30-day mortality was substantially higher in the conservative treatment group than in the invasive treatment group (27% vs. 10%; p = 0.02). Conclusion: Our data suggested that despite concerns regarding the safety of the primary PCI strategy in the older adult STEMI population, this treatment strategy was associated with a survival benefit.

#ST elevation myocardial infarction #STEMI #Alder adults #Conservative treatment #Invasive treatment

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