Literature DB >> 22538794

Are the elderly different? Factors influencing mortality after percutaneous coronary intervention with stent implantation.

J Schröder1, U Müller-Werdan, S Reuter, A Vogt, M Schlitt, U Raaz, I Reindl, M Buerke, K Werdan, A Schlitt.   

Abstract

BACKGROUND: The aim of this study was to investigate factors influencing mortality after percutaneous coronary intervention (PCI) in patients aged ≥ 75 years compared to younger patients. PATIENTS AND METHODS: A total of 1,809 coronary heart disease (CHD) patients after PCI with stent implantation in our hospital were assessed. Kaplan-Meier analyses with log-rank test and Cox regression analyses were performed on three predefined models concerning primary endpoint of all-cause mortality. Model 1 was a univariate analysis of the influence of age dichotomized by age 75 years on the primary endpoint. Model 2 included age and classical cardiovascular risk factors (CVRFs, e.g., body mass index (BMI), smoking, diabetes, and hypertension). Model 3 consisted of age, classical CVRFs, and additional factors (e.g., medication; hemoglobin, peripheral arterial disease (PAD), low-density lipoprotein cholesterol (LDL-C) and creatinine levels, and left ventricular ejection fraction (LVEF)).
RESULTS: In the mean follow-up of 137 ± 61 weeks 375 patients died. Age ≥ 75 years was significantly related to mortality in all models. In model 3, previous stroke, PAD, diabetes, elevated levels of serum creatinine, and increased LDL-C were related to elevated mortality, higher hemoglobin levels, and LVEF > 50% were associated with decreased mortality in all patients and in patients < 75 years. In patients ≥ 75 years arterial hypertension was associated with poor outcome (hazard ratio (HR) 7.989, p = 0.040), previous antiplatelet therapy showed reduced mortality (HR 0.098, p = 0.039).
CONCLUSION: Although risk factors such as previous stroke, PAD, diabetes, renal insufficiency, and anemia were predictors for death in all patients and patients < 75 years, in the elderly only arterial hypertension increased, whereas treatment with platelet inhibitors decreased mortality.

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Year:  2013        PMID: 22538794     DOI: 10.1007/s00391-012-0338-y

Source DB:  PubMed          Journal:  Z Gerontol Geriatr        ISSN: 0948-6704            Impact factor:   1.281


  15 in total

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2.  European guidelines on cardiovascular disease prevention in clinical practice: full text. Fourth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts).

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5.  Effect of anemia in high-risk groups of patients with acute myocardial infarction treated with percutaneous coronary intervention.

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7.  Characteristics and baseline clinical predictors of future fatal versus nonfatal coronary heart disease events in older adults: the Cardiovascular Health Study.

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Journal:  Circulation       Date:  2006-05-01       Impact factor: 29.690

Review 8.  Role of antiplatelet drugs in the prevention of cardiovascular events.

Authors:  Michal Tendera; Wojciech Wojakowski
Journal:  Thromb Res       Date:  2003-06-15       Impact factor: 3.944

9.  Immediate and long-term results of coronary angioplasty in patients aged 80 years and older.

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Journal:  Cardiol Res Pract       Date:  2010-06-20       Impact factor: 1.866

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  2 in total

1.  Nitrated apolipoprotein AI/apolipoprotein AI ratio is increased in diabetic patients with coronary artery disease.

Authors:  Xueying Chen; Ahmed Bakillah; Liye Zhou; Xiaoyue Pan; Florian Hoepfner; Marrit Jacob; Xian-Cheng Jiang; Jason Lazar; Axel Schlitt; M Mahmood Hussain
Journal:  Atherosclerosis       Date:  2015-11-24       Impact factor: 5.162

Review 2.  Redox signalling and cardioprotection: translatability and mechanism.

Authors:  P Pagliaro; C Penna
Journal:  Br J Pharmacol       Date:  2015-01-12       Impact factor: 8.739

  2 in total

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