Short-and Long–Term Follow–up in the Elderly Patients With ST–Elevation Myocardial Infarction Receiving Primary Angioplasty or Thrombolytic Therapy
Open Access
- 20 February 2019
- journal article
- Published by Armenian Green Publishing Co. in International Journal of Cardiovascular Practice
- Vol. 4 (1), 10-15
- https://doi.org/10.21859/ijcp-403
Abstract
78 Introduction: The ischemic time serves as the most important parameter for treatment choice in patients with ST–elevation myocardial infarction (STEMI). The current study aimed at comparing the short– and long–term follow–up of elderly patients with STEMI undergoing primary angioplasty (PCI) or thrombolytic therapy. Methods: The current cross sectional study was conducted on all patients aged >65 years, admitted to the emergency department of Imam Hossein Hospital, Tehran, Iran from January 2014 to July 2016, diagnosed with STEMI . The demographics, medical history, family history, and mediation history were recorded for all patients. Patients received PCI or thrombolytic therapy based on the ischemic time and the treatment outcome and the following events were recorded. Patients were contacted after six months and data of their death or used treatments were recorded. All data were compared between the groups. Results: Of all patients, 38 subjects received thrombolytic therapy and 62 PCI. There was no significant difference between the groups in terms of mean age and gender (P=0.5 and 0.1, respectively). The frequency of positive medical history and smoking did not differ between the groups. There was no difference in the mean values of vital signs or serum parameters, mean ischemic time, left ventricular ejection fraction (LVEF), frequency of pulmonary emboli, cardiogenic shock, the involved vessel, and post-treatment complications between the groups (P>0.05). Of the 14 cases that died after six months, five were in the thrombolytic therapy group and nine in the PCI group (P=0.8). Mean hospital stay was not different between the groups (P=0.5). Conclusions: The results of the present study on two groups with similar demographics showed no significant difference between the groups in terms of the short– and long–term follow–up of PCI and thrombolytic therapy. The results indicated the appropriateness of treatment choice based on ischemic time and the available methods.Keywords
This publication has 22 references indexed in Scilit:
- Heart Disease and Stroke Statistics—2016 UpdateCirculation, 2016
- Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013The Lancet, 2014
- Quality of Life in Cardiovascular Patients in Iran and Factors Affecting It: A Systematic Review2012
- ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevationEuropean Heart Journal, 2012
- Growing Epidemic of Coronary Heart Disease in Low- and Middle-Income CountriesCurrent Problems in Cardiology, 2010
- Long-term Outcome of Primary Percutaneous Coronary Intervention vs Prehospital and In-Hospital Thrombolysis for Patients With ST-Elevation Myocardial InfarctionJAMA, 2006
- ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction—Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction)Journal of the American College of Cardiology, 2004
- Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trialsThe Lancet, 2003
- Treatment of Acute Myocardial Infarction and 30-Day Mortality among Women and MenThe New England Journal of Medicine, 2000
- The Volume of Primary Angioplasty Procedures and Survival after Acute Myocardial InfarctionThe New England Journal of Medicine, 2000