PMID- 20853070
OWN - NLM
STAT- MEDLINE
DCOM- 20110615
LR  - 20211020
IS  - 1970-9366 (Electronic)
IS  - 1828-0447 (Linking)
VI  - 6
IP  - 1
DP  - 2011 Feb
TI  - Predictors of the early outcome in elderly patients with ST elevation myocardial 
      infarction treated with primary angioplasty: a single center experience.
PG  - 41-6
LID - 10.1007/s11739-010-0459-5 [doi]
AB  - 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.
FAU - Lazzeri, Chiara
AU  - Lazzeri C
AD  - Intensive Cardiac Coronary Unit, Heart and Vessel Department, Azienda 
      Ospedaliero-Universitaria Careggi, Florence, Italy. lazzeric@libero.it
FAU - Valente, Serafina
AU  - Valente S
FAU - Chiostri, Marco
AU  - Chiostri M
FAU - Picariello, Claudio
AU  - Picariello C
FAU - Gensini, Gian Franco
AU  - Gensini GF
LA  - eng
PT  - Journal Article
DEP - 20100918
PL  - Italy
TA  - Intern Emerg Med
JT  - Internal and emergency medicine
JID - 101263418
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - *Angioplasty, Balloon, Coronary
MH  - Coronary Angiography
MH  - Female
MH  - Humans
MH  - Hyperglycemia
MH  - Male
MH  - Myocardial Infarction/diagnosis/mortality/*therapy
MH  - *Outcome Assessment, Health Care
EDAT- 2010/09/21 06:00
MHDA- 2011/06/16 06:00
CRDT- 2010/09/21 06:00
PHST- 2010/07/05 00:00 [received]
PHST- 2010/08/31 00:00 [accepted]
PHST- 2010/09/21 06:00 [entrez]
PHST- 2010/09/21 06:00 [pubmed]
PHST- 2011/06/16 06:00 [medline]
AID - 10.1007/s11739-010-0459-5 [doi]
PST - ppublish
SO  - Intern Emerg Med. 2011 Feb;6(1):41-6. doi: 10.1007/s11739-010-0459-5. Epub 2010 
      Sep 18.