PMID- 27381859 OWN - NLM STAT- MEDLINE DCOM- 20170807 LR - 20170817 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 217 Suppl DP - 2016 Aug TI - Factors associated with use of percutaneous coronary intervention among elderly patients presenting with ST segment elevation acute myocardial infarction (STEMI): Results from the ISACS-TC registry. PG - S21-6 LID - S0167-5273(16)31233-5 [pii] LID - 10.1016/j.ijcard.2016.06.227 [doi] AB - BACKGROUND: A substantial proportion of elderly with ST segment elevation myocardial infarction (STEMI) do not undergo percutaneous coronary intervention (PCI). We sought to investigate factors associated with the decision not to perform coronary angiography at admission in these patients. METHODS: We evaluated 1315 STEMI patients aged >/=75years old enrolled in the International Survey of Acute Coronary Syndromes in Transitional Countries (ISACS TC) registry between October 2010 and February 2015. They were compared with 6667 patients aged <75years old enrolled in the registry in the same time frame. RESULTS: Elderly patients were less likely to undertake invasive coronary evaluation compared with younger patients (62.1% vs. 78.9; p<0.001%). In the older group there were a lower proportion of patients presenting <12h after symptom onset (66.5% vs.76.9%, p<0.001), and a higher prevalence of comorbidities. Few elderly were treated with current recommended evidence based treatments (aspirin, clopidogrel, heparins, beta-blocker, statins, and ACE-inhibitors). Logistic analysis adjusted for age and sex showed that older age was associated with underuse of coronary angiography (OR 0.46, 95% CI: 0.41-0.53, p<0.001). Clinical factors that were associated with underuse of angiography in patients over 75 were: female sex (OR: 0.77), presence of comorbidities (OR: 0.91), anemia (OR: 0.44) and late hospital admission (OR: 0.89). CONCLUSIONS: In the ISACS-TC, more than one third of the elderly with STEMI did not undergo coronary angiography at admission. Sex, comorbidities, and late hospital admission were independent factors associated with the underuse of PCI in these patients. CI - Copyright (c) 2016. Published by Elsevier Ireland Ltd. FAU - Calmac, Lucian AU - Calmac L AD - Department of Cardiology, Clinical Emergency Hospital Bucharest, Bucharest, Romania. FAU - Bataila, Vlad AU - Bataila V AD - Department of Cardiology, Clinical Emergency Hospital Bucharest, Bucharest, Romania. FAU - Ricci, Beatrice AU - Ricci B AD - Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy. FAU - Vasiljevic, Zorana AU - Vasiljevic Z AD - Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia. FAU - Kedev, Sasko AU - Kedev S AD - University Clinic of Cardiology, University "Ss. Cyril and Methodius", Skopje, Macedonia. FAU - Gustiene, Olivija AU - Gustiene O AD - Department of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania. FAU - Trininic, Dijana AU - Trininic D AD - University Clinical Centre of the Republic of Srpska, Clinic of Cardiovascular Diseases, Banja Luka, Republika Srpska, Bosnia and Herzegovina. FAU - Knezevic, Bozidarka AU - Knezevic B AD - Clinical Center of Montenegro, Center of Cardiology, Podgorica, Montenegro. FAU - Milicic, Davor AU - Milicic D AD - Department for Cardiovascular Diseases, University of Zagreb, Zagreb, Croatia. FAU - Dilic, Mirza AU - Dilic M AD - Clinical Center University of Sarajevo, Bolnicka 25, Sarajevo, Bosnia and Herzegovina. FAU - Manfrini, Olivia AU - Manfrini O AD - Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy. FAU - Cenko, Edina AU - Cenko E AD - Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy. FAU - Badimon, Lina AU - Badimon L AD - Cardiovascular Research Center, CSIC-ICCC, Hospital de la Santa Creu i Sant Pau, Institute Carlos III, Autonomous University of Barcelona, Barcelona, Spain. FAU - Bugiardini, Raffaele AU - Bugiardini R AD - Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy. FAU - Scafa-Udriste, Alexandru AU - Scafa-Udriste A AD - Department of Cardiology, Clinical Emergency Hospital Bucharest, Bucharest, Romania; Bucharest University of Medicine and Pharmacy Carol Davila, Bucharest, Romania. FAU - Tautu, Oana AU - Tautu O AD - Department of Cardiology, Clinical Emergency Hospital Bucharest, Bucharest, Romania; Bucharest University of Medicine and Pharmacy Carol Davila, Bucharest, Romania. FAU - Dorobantu, Maria AU - Dorobantu M AD - Department of Cardiology, Clinical Emergency Hospital Bucharest, Bucharest, Romania; Bucharest University of Medicine and Pharmacy Carol Davila, Bucharest, Romania. Electronic address: maria.dorobantu@gmail.com. LA - eng PT - Journal Article DEP - 20160629 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM MH - Aged MH - Aged, 80 and over MH - Coronary Angiography MH - Disease Management MH - Female MH - Humans MH - Logistic Models MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/*methods MH - Registries MH - Risk Factors MH - ST Elevation Myocardial Infarction/diagnostic imaging/*surgery MH - Treatment Outcome OTO - NOTNLM OT - Coronary angiography OT - Elderly OT - Reperfusion therapy OT - STEMI EDAT- 2016/07/07 06:00 MHDA- 2017/08/08 06:00 CRDT- 2016/07/07 06:00 PHST- 2016/05/31 00:00 [received] PHST- 2016/06/25 00:00 [accepted] PHST- 2016/07/07 06:00 [entrez] PHST- 2016/07/07 06:00 [pubmed] PHST- 2017/08/08 06:00 [medline] AID - S0167-5273(16)31233-5 [pii] AID - 10.1016/j.ijcard.2016.06.227 [doi] PST - ppublish SO - Int J Cardiol. 2016 Aug;217 Suppl:S21-6. doi: 10.1016/j.ijcard.2016.06.227. Epub 2016 Jun 29.