PMID- 26482627
OWN - NLM
STAT- MEDLINE
DCOM- 20160915
LR  - 20151113
IS  - 1768-3181 (Electronic)
IS  - 0003-3928 (Linking)
VI  - 64
IP  - 5
DP  - 2015 Nov
TI  - [ST elevation myocardial infarction (STEMI) in patients aged 85 and over. 
      Invasive management versus exclusive medical treatment: Departmental study].
PG  - 345-51
LID - S0003-3928(15)00162-6 [pii]
LID - 10.1016/j.ancard.2015.09.040 [doi]
AB  - INTRODUCTION: Percutaneous coronary intervention (PCI) and/or fibrinolysis for 
      management of an ST elevation myocardial infarction (STEMI) are at high risk in 
      the elderly. Is there any place for an invasive management in this particular 
      population? METHODS: It is a single-center retrospective study (CHD Vendee, La 
      Roche-sur-Yon) including patients aged 85 and over who had STEMI between January 
      2008 and December 2013, divided into two groups: coronary angiogram/fibrinolysis 
      ("invasive") versus exclusive medical treatment ("non-invasive"), comparing 
      mortality, morbidity, complications and loss of independence. RESULTS: Among the 
      1373 patients hospitalized for STEMI, 118 (8.6%) were included: 71 (60.2%) 
      underwent an invasive procedure for reperfusion whereas 47 had "non-invasive" 
      management. All cause mortality rate was higher in the "non-invasive" group (28% 
      versus 45%; P=0.077 NS). The identified pejorative criteria are age, female 
      gender, past history of severe valvular disease, and delay for primary care. No 
      difference was found in intrahospital complication rate (23 vs 21; P=0.21) nor in 
      loss of independence. CONCLUSION: The invasive management of STEMI in the elderly 
      may reduce the one-year mortality rate without increasing morbidity.
CI  - Copyright (c) 2015 Elsevier Masson SAS. All rights reserved.
FAU - Doizon, T
AU  - Doizon T
AD  - Service de cardiologie, CHD de Vendee, Les Oudairies, 85000 La Roche-sur-Yon, 
      France. Electronic address: thomas.doizon@chd-vendee.fr.
FAU - Orion, L
AU  - Orion L
AD  - Service de cardiologie, CHD de Vendee, Les Oudairies, 85000 La Roche-sur-Yon, 
      France.
FAU - Dimet, J
AU  - Dimet J
AD  - Service de recherche clinique, CHD de Vendee, Les Oudairies, 85000 La 
      Roche-sur-Yon, France.
FAU - Boiffard, E
AU  - Boiffard E
AD  - Service de cardiologie, CHD de Vendee, Les Oudairies, 85000 La Roche-sur-Yon, 
      France.
LA  - fre
PT  - Comparative Study
PT  - English Abstract
PT  - Journal Article
TT  - Syndrome coronarien aigu avec sus-decalage du segment ST chez les patients de 
      85ans et plus. Prise en charge invasive versus traitement medical exclusif: etude 
      departementale.
DEP - 20151021
PL  - France
TA  - Ann Cardiol Angeiol (Paris)
JT  - Annales de cardiologie et d'angeiologie
JID - 0142167
SB  - IM
MH  - Aged, 80 and over
MH  - Cardiovascular Diseases
MH  - Electrocardiography
MH  - Female
MH  - Humans
MH  - Male
MH  - Myocardial Infarction/physiopathology/*therapy
MH  - *Percutaneous Coronary Intervention
MH  - Retrospective Studies
MH  - *Thrombolytic Therapy
OTO - NOTNLM
OT  - Elderly patients
OT  - Myocardial revascularization
OT  - Reperfusion myocardique
OT  - ST elevation myocardial infarction
OT  - Sujets ages
OT  - Syndrome coronarien aigu ST+
OT  - Vendee
EDAT- 2015/10/21 06:00
MHDA- 2016/09/16 06:00
CRDT- 2015/10/21 06:00
PHST- 2015/07/31 00:00 [received]
PHST- 2015/09/03 00:00 [accepted]
PHST- 2015/10/21 06:00 [entrez]
PHST- 2015/10/21 06:00 [pubmed]
PHST- 2016/09/16 06:00 [medline]
AID - S0003-3928(15)00162-6 [pii]
AID - 10.1016/j.ancard.2015.09.040 [doi]
PST - ppublish
SO  - Ann Cardiol Angeiol (Paris). 2015 Nov;64(5):345-51. doi: 
      10.1016/j.ancard.2015.09.040. Epub 2015 Oct 21.