Changing Trends In, and Characteristics Associated With, Not Undergoing Cardiac Catheterization in Elderly Adults Hospitalized with ST-Segment Elevation Acute Myocardial Infarction

Overview

Journal J Am Geriatr Soc

Specialty Geriatrics

Date 2015 May 6

PMID 25940950

Citations 3

Authors

Mayra Tisminetzky

Nathaniel Erskine

Han-Yang Chen

Joel Gore

Jerry Gurwitz

Jorge Yarzebski

Samuel Joffe

Peter Shaw

Robert Goldberg

Affiliations

Soon will be listed here.

Abstract

Objectives: To describe decade- long trends (1999-2009) in the rates of not undergoing cardiac catheterization and percutaneous coronary intervention (PCI) in individuals aged 65 and older presenting with an ST-segment elevation acute myocardial infarction (STEMI) and factors associated with not undergoing these procedures.

Design: Observational population-based study.

Setting: Worcester, Massachusetts, metropolitan area.

Participants: Individuals aged 65 and older hospitalized for an STEMI in six biennial periods between 1999 and 2009 at 11 central Massachusetts medical centers (N=960).

Measurements: Analyses were conducted to examine the characteristics of people who did not undergo cardiac catheterization overall and stratified into two age strata (65-74, ≥75).

Results: Between 1999 and 2009, dramatic declines (from 59.4% to 7.5%) were observed in the proportion of older adults who did not undergo cardiac catheterization at all greater Worcester hospitals. These declines were observed in individuals aged 65 to 74 (58.4-6.7%) and in those aged 75 and older (69.4-13.5%). The proportion of individuals not undergoing PCI after undergoing cardiac catheterization decreased from 36.6% in 1999 to 6.5% in 2009. Women, individuals with a prior MI, those with do-not-resuscitate orders, and those with various comorbidities were less likely to have undergone these procedures than comparison groups.

Conclusion: Older adults who develop an STEMI are increasingly likely to undergo cardiac catheterization and PCI, but several high-risk groups remain less likely to undergo these procedures.

Citing Articles

Percutaneous Coronary Intervention in Older Patients With ST-Segment Elevation Myocardial Infarction and Cardiogenic Shock.

Damluji A, Bandeen-Roche K, Berkower C, Boyd C, Al-Damluji M, Cohen M J Am Coll Cardiol. 2019; 73(15):1890-1900.

PMID: 30999991 PMC: 7185801. DOI: 10.1016/j.jacc.2019.01.055.

Elderly Patients with ST-Segment Elevation Myocardial Infarction: A Patient-Centered Approach.

Lattuca B, Kerneis M, Zeitouni M, Cayla G, Guedeney P, Collet J Drugs Aging. 2019; 36(6):531-539.

PMID: 30953328 DOI: 10.1007/s40266-019-00663-y.

Acute myocardial infarction in the elderly.

Zijlstra F, de Boer M Neth Heart J. 2015; 23(10):475-476.

PMID: 26382647 PMC: 4580669. DOI: 10.1007/s12471-015-0751-0.

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