PMID- 33010099
OWN - NLM
STAT- MEDLINE
DCOM- 20211020
LR  - 20211020
IS  - 1522-726X (Electronic)
IS  - 1522-1946 (Linking)
VI  - 98
IP  - 4
DP  - 2021 Oct
TI  - ST-elevation myocardial infarction in nonagenarians: A nationwide analysis of 
      trends and outcomes in the United States.
PG  - 638-646
LID - 10.1002/ccd.29313 [doi]
AB  - OBJECTIVE: To assess ST elevation myocardial infarction (STEMI) trends and 
      outcomes in nonagenarians undergoing primary percutaneous coronary intervention 
      (pPCI) compared to medical management. BACKGROUND: Although nonagenarians (age 
      greater than 90 years) represent the fast-growing age decade of the US 
      population, limited evidence is available regarding trends and outcomes of 
      treatment strategies for STEMI in this population cohort. METHODS: We performed a 
      retrospective analysis using the National Inpatient Sample (NIS) database to 
      identify nonagenarians presenting with STEMI and treated with either pPCI or 
      medical management. In-hospital mortality, in-hospital complications, length of 
      stay and in-hospital costs were analyzed. RESULTS: Between 2010-2017, 41,042 
      STEMI hospitalizations were identified in nonagenarians, of which 11, 155 (27.2%) 
      included pPCI whereas 29, 887 (72.8%) included medical management. STEMI 
      hospitalizations among nonagenarians decreased over the study period. Overall 
      unadjusted in-hospital mortality was 21.6%, and the hospitalizations that 
      included pPCI had significantly lower mortality compared to the medical 
      management (13.6% vs. 24.5%, p < .001). After adjusting for baseline 
      characteristics, hospitalizations that included pPCI had 42.1% lower odds of 
      in-hospital mortality (adjusted OR: 0.58, 95% CI: 0.50 to 0.67, p < .001). 
      Altogether, in-hospital cardiac, bleeding and vascular complications, length of 
      stay and in-hospital costs were higher in pPCI hospitalizations. CONCLUSION: In 
      nonagenarians, STEMI mortality is high, but pPCI is associated with superior 
      outcomes compared to medical management alone. Therefore, pPCI can be considered 
      an acceptable treatment strategy in this population.
CI  - (c) 2020 Wiley Periodicals LLC.
FAU - Pajjuru, Venkata S
AU  - Pajjuru VS
AUID- ORCID: 0000-0002-1914-3998
AD  - Department of Medicine, Creighton University School of Medicine, Omaha, Nebraska.
FAU - Thandra, Abhishek
AU  - Thandra A
AD  - Department of Medicine, Division of Cardiology, Creighton University School of 
      Medicine, Omaha, Nebraska.
FAU - Guddeti, Raviteja R
AU  - Guddeti RR
AD  - Department of Medicine, Division of Cardiology, Creighton University School of 
      Medicine, Omaha, Nebraska.
FAU - Kothapalli, Srikanth R
AU  - Kothapalli SR
AD  - Department of Medicine, Creighton University School of Medicine, Omaha, Nebraska.
FAU - Walters, Ryan W
AU  - Walters RW
AD  - Department of Medicine, Division of Clinical Research and Evaluative Sciences, 
      Creighton University School of Medicine, Omaha, Nebraska.
FAU - Jhand, Aravdeep
AU  - Jhand A
AD  - Department of Medicine, Division of Cardiovascular Medicine, University of 
      Nebraska Medical Center, Omaha, Nebraska.
FAU - Aboeata, Ahmed
AU  - Aboeata A
AD  - Department of Medicine, Division of Cardiology, Creighton University School of 
      Medicine, Omaha, Nebraska.
FAU - Andukuri, Venkata G
AU  - Andukuri VG
AD  - Department of Medicine, Creighton University School of Medicine, Omaha, Nebraska.
FAU - Goldsweig, Andrew M
AU  - Goldsweig AM
AUID- ORCID: 0000-0003-2952-7837
AD  - Department of Medicine, Division of Cardiovascular Medicine, University of 
      Nebraska Medical Center, Omaha, Nebraska.
LA  - eng
PT  - Journal Article
DEP - 20201003
PL  - United States
TA  - Catheter Cardiovasc Interv
JT  - Catheterization and cardiovascular interventions : official journal of the 
      Society for Cardiac Angiography & Interventions
JID - 100884139
SB  - IM
CIN - Catheter Cardiovasc Interv. 2021 Oct;98(4):647-648. PMID: 34596331
MH  - Aged, 80 and over
MH  - Hospital Mortality
MH  - Humans
MH  - *Percutaneous Coronary Intervention/adverse effects
MH  - Retrospective Studies
MH  - Risk Factors
MH  - *ST Elevation Myocardial Infarction/diagnostic imaging/surgery
MH  - Treatment Outcome
MH  - United States/epidemiology
OTO - NOTNLM
OT  - STEMI
OT  - nonagenarians
OT  - outcomes
OT  - pPCI
OT  - temporal trends
EDAT- 2020/10/04 06:00
MHDA- 2021/10/21 06:00
CRDT- 2020/10/03 12:05
PHST- 2020/09/03 00:00 [revised]
PHST- 2020/07/08 00:00 [received]
PHST- 2020/09/21 00:00 [accepted]
PHST- 2020/10/04 06:00 [pubmed]
PHST- 2021/10/21 06:00 [medline]
PHST- 2020/10/03 12:05 [entrez]
AID - 10.1002/ccd.29313 [doi]
PST - ppublish
SO  - Catheter Cardiovasc Interv. 2021 Oct;98(4):638-646. doi: 10.1002/ccd.29313. Epub 
      2020 Oct 3.