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Soo Hoo SY, Gallagher R, Elliott D. Systematic review of health-related quality of life in older people following percutaneous coronary intervention. Nurs Health Sci 2014; 16:415-27. [PMID: 24779852 DOI: 10.1111/nhs.12121] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 11/10/2013] [Accepted: 11/25/2013] [Indexed: 11/29/2022]
Abstract
People aged over 60 years represent an increasingly high proportion of the population undergoing percutaneous coronary intervention. While risks are greater for older people in terms of major adverse cardiovascular events and higher mortality for this treatment, it is unclear if the benefits of health-related quality of life outcomes may outweigh risks. A search of the PubMed, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Excerpta Medica, and Cochrane databases was conducted for the period from January 1999 to June 2012 using key words "percutaneous coronary intervention"/"angioplasty," "older," "elderly," and "quality of life"/"health-related quality of life." Using a systematic review approach, data from 18 studies were extracted for description and synthesis. Findings revealed that everyone regardless of age reported better health-related quality of life, primarily from the relief of angina and improved physical and mental function. Age itself did not have an independent predictive effect when other factors such as comorbid conditions were taken into account. Assessment of older peoples' health status following percutaneous coronary intervention by nurses and other health professionals is therefore important for the provision of quality care.
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Affiliation(s)
- Soon Yeng Soo Hoo
- Faculty of Health, University of Technology, Sydney, Australia; Department of Cardiology, Royal North Shore Hospital, Sydney, Australia
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A Study of Prognosis, Outcome, and Changing Tendency of Hospitalized AMI Patients in Beijing Third-Grade A-Level Traditional Chinese Medicine Hospitals from 1999 to 2008. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:837194. [PMID: 22536293 PMCID: PMC3319064 DOI: 10.1155/2012/837194] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Accepted: 01/12/2012] [Indexed: 11/20/2022]
Abstract
Objectives. To survey and analyse the prognosis, outcome, and changing tendency of the Acute Myocardial Infarction (AMI) patients in Beijing third-grade A-level Traditional Chinese Medicine (TCM) hospitals. Methods. We collected the clinical datum of hospitalized AMI patients in Beijing 6 TCM hospitals from January 1999 to December 2008 and then analysed the clinical datum. Results. (1) The mean age of patients had showed a slowly rising tendency during this ten years. The patients who had previous history of cerebrovascular diseasea and multiple comorbidities had increased year by year. (2) The rate of reperfusion therapy, revascularization and standardized using of drug, and usage of TCM of AMI patients presented a significant increasing tendency in these hospitals. (3) The proportion of AMI patients combined with cardiac arrhythmia and heart failure had decreased significantly. (4) The AMI mortality presented a decreasing tendency in 10 years. Conclusions. The AMI patients in Beijing TCM hospitals had their own unique clinical features, and it can improve their prognosis by combined therapy of Western Medicine and Traditional Chinese Medicine.
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Zimmermann S, Ruthrof S, Nowak K, Klinghammer L, Ludwig J, Daniel WG, Flachskampf FA. Outcomes of contemporary interventional therapy of ST elevation infarction in patients older than 75 years. Clin Cardiol 2009; 32:87-93. [PMID: 19215008 DOI: 10.1002/clc.20289] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Data on contemporary real-world outcomes of interventional revascularization in patients > or = 75 y of age with ST elevation infarction (STEMI) are limited. METHODS We analyzed all 504 consecutive patients who underwent angiography for acute STEMI between 1999 and 2005 at our center, and followed them up over one year. Outcomes in patients > or = 75 y of age were compared with younger patients. RESULTS Patients > or = 75 y of age (n = 115) were majority females (55% versus 21%, p < 0.001), more cases of diabetes (42% versus 27%, p = 0.004), hypertension (78% versus 65%, p = 0.03) and a history of coronary events (25% versus 15%, p = 0.002). Younger patients were more often smokers (63% versus 30%, p < 0.001). After coronary angiography patients > or = 75 y of age underwent less frequent intervention (PCI; 84% versus 93%, p = 0.01). However, if PCI was performed, technical success rates were similar to younger patients (84% versus 86%). The 30-d mortality was 13% versus 6.4% (p = 0.03), but after successful PCI, the 30-d mortality rate was not significantly higher in old patients (7.4% versus 3.9%, p = 0.23). Bleeding complications were very low in both age groups if the radial access route was chosen. Multivariate predictors of 30-d mortality were cardiogenic shock/survived cardiac arrest, ejection fraction < 30%, conservative treatment or unsuccessful PCI (OR 3.01), renal insufficiency, diabetes, and age. One-y mortality was higher in the elderly (24.3% versus 9.9%, p < 0.001). Among 30-d-survivors, only multivessel disease and age were multivariate predictors of 1-y mortality. CONCLUSION Patients > or = 75 y of age benefit from PCI in STEMI, and failed or unattempted PCI worsens prognosis in the old as well as in younger patients.
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Affiliation(s)
- Stefan Zimmermann
- Med.Klinik 2, Universitätsklinikum Erlangen, 91054 Erlangen, Germany
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Cho JY, Jeong MH, Ahn Y, Chae SC, Seong IH, Kim YJ, Yoon J, Rhew JY, Chae JK, Chae IH, Lee NH, Hwang JY, Cho MC, Kim KS, Kim CJ, Chung WS, Rha SW, Jang YS, Seung KB, Park SJ. Predictive Factors of Major Adverse Cardiac Events and Clinical Outcomes of Acute Myocardial Infarction in Young Korean Patients. Korean Circ J 2008. [DOI: 10.4070/kcj.2008.38.3.161] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Jae Yeong Cho
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Myung Ho Jeong
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Youngkeun Ahn
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Shung Chull Chae
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - In Hwan Seong
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Young Jo Kim
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Junghan Yoon
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Jay Young Rhew
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Jei Keon Chae
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - In Ho Chae
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Nae Hee Lee
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Jin Yong Hwang
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Myeong Chan Cho
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Kee Sik Kim
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Chong Jin Kim
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Wook Sung Chung
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Seung Woon Rha
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Yang Soo Jang
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Ki Bae Seung
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
| | - Seung Jung Park
- Korea Acute Myocardial Infarction Registry of the Korean Society of Cardiology, Gwangju, Korea
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Cho JY, Jeong MH, Choi OJ, Lee S, Jeong SY, Kim IS, Cho JS, Hwang SH, Hwang SH, Yoon NS, Moon JY, Hong YJ, Kim JH, Kim W, Ahn YK, Cho JG, Park JC, Kang JC. Predictive Factors after Percutaneous Coronary Intervention in Young Patients with Acute Myocardial Infarction. Korean Circ J 2007. [DOI: 10.4070/kcj.2007.37.8.373] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Jae Yeong Cho
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Myung Ho Jeong
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Ok Ja Choi
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Seok Lee
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Seon Young Jeong
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - In Soo Kim
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Jung Sun Cho
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Seung Hwan Hwang
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Sun Ho Hwang
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Nam Sik Yoon
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Jae Youn Moon
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Young Joon Hong
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Ju Han Kim
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Weon Kim
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Young Keun Ahn
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Jeong Gwan Cho
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Jong Chun Park
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Jung Chaee Kang
- The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
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Sakai K, Nakagawa Y, Soga Y, Ando K, Yokoi H, Iwabuchi M, Yasumoto H, Nosaka H, Nobuyoshi M. Comparison of 30-day outcomes in patients <75 years of age versus >or=75 years of age with acute myocardial infarction treated by primary coronary angioplasty. Am J Cardiol 2006; 98:1018-21. [PMID: 17027563 DOI: 10.1016/j.amjcard.2006.05.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2006] [Revised: 05/08/2006] [Accepted: 05/08/2006] [Indexed: 11/26/2022]
Abstract
We reviewed 1,087 consecutive patients treated by primary coronary angioplasty for acute myocardial infarction; 309 were >or=75 and 778 were <75 years of age. Compared with the younger group, the older group had higher 30-day (8.1% vs 4.0%, p = 0.0057) and cardiac (6.5% vs 3.6%, p = 0.038) mortality rates. Successful reperfusion was achieved in the 2 groups at a similarly high rate (91.6% and 92.9%, p = 0.45). Successful compared with unsuccessful angioplasty decreased 30-day mortality rates in the older group (6.0% vs 30.8%, p <0.0001) and in the younger group (3.2% vs 14.5%, p <0.0001). When reperfusion was successful, the cardiac mortality rate in older patients was not significantly greater than that in younger patients (4.6% vs 2.8%, p = 0.14). By multivariate analysis in all 1,087 patients, overt cardiogenic shock on admission (odds ratio 44.7, 95% confidence interval 22.0 to 91.1, p <0.0001) and unsuccessful reperfusion (odds ratio 9.40, 95% confidence interval 4.11 to 21.5, p <0.0001) were found to be independent predictors of 30-day mortality, whereas age >or=75 years (odds ratio 1.79, 95% confidence interval 0.91 to 3.50, p = 0.090) was not. In conclusion, aggressive angioplasty in older patients improves prognosis.
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Affiliation(s)
- Koyu Sakai
- Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan
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Hirakawa Y, Masuda Y, Kuzuya M, Kimata T, Iguchi A, Uemura K. Effect of Emergency Percutaneous Coronary Intervention on In-Hospital Mortality of Very Elderly (80+ Years of Age) Patients With Acute Myocardial Infarction. Int Heart J 2006; 47:663-9. [PMID: 17106137 DOI: 10.1536/ihj.47.663] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
It is still controversial whether percutaneous coronary intervention (PCI) is effective in improving in-hospital survival in very elderly patients. Therefore, using data from the Tokai Acute Myocardial Infarction Study II, we studied the effect of emergency PCI on the in-hospital mortality of very elderly (80+ years of age) patients with acute myocardial infarction (AMI). The study was a prospective study of all consecutive patients admitted to the 15 acute care hospitals in the Tokai region with the diagnosis of AMI from 2001 to 2003. A total of 211 patients undergoing emergency PCI and 176 patients not undergoing PCI were included in the present analysis. We compared the baseline and procedural characteristics and the clinical outcomes between the 2 groups. Patients without emergency PCI were older and had an increased prevalence of female gender, ADL impairment, and dementia in comparison with those with PCI. They also showed poorer clinical conditions. They were less likely to be transferred to intensive care or coronary care units and to be given intra-aortic balloon pumps. The patients with emergency PCI had nearly one-third the in-hospital mortality rate of the patients without emergency PCI. According to multivariate analysis, emergency PCI was still identified as an independent predictor of in-hospital death, with an adjusted odds ratio of 0.26 (95% CI, 0.07-0.97). The results indicated that emergency PCI has a preventative effect on in-hospital mortality in Japanese AMI patients 80 years of age and older.
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Affiliation(s)
- Yoshihisa Hirakawa
- Department of Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
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Dangelser G, Gottwalles Y, Huk M, de Poli F, Levai L, Boulenc JM, Monassier JP, Jacquemin L, Couppie P, Hanssen M. Infarctus du myocarde du sujet de plus de 75 ans. Presse Med 2005; 34:983-9. [PMID: 16225249 DOI: 10.1016/s0755-4982(05)84096-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES This prospective multicenter study assessed the prevalence and feasibility of percutaneous coronary angioplasty (PTCA) in the acute phase of ST-elevation myocardial infarction (STEMI) in 3 nonacademic interventional cardiology centers (Alsace, France). METHODS We studied the clinical characteristics, angiographic data, and PCTA results of all STEMI patients and analyzed the revascularization rates and adverse events during hospitalization. We compared patients at least 75 years of age and younger patients for these data and with the literature. RESULTS Of the 1672 patients admitted for STEMI, 342 (20.45%) were at least 75 years of age. Half the patients in this high-risk subgroup were women. These patients had more co-morbidities (e.g., hypertension and diabetes mellitus) than younger patients, and more of them had three-vessel disease. Mortality rate was high in this subgroup and always higher than for comparable younger subjects, but it varied according to the initial clinical profile. Their global mortality rate was 20.47%, but it fell to 5.41% when we excluded patients with cardiogenic shock or in Killip stage ill, and those who were resuscitated. PTCA is a coronary reperfusion technique especially indicated for elderly patients with STEMI. It is an effective revascularization technique, with a reperfusion rate (exclusively TIMI III flow) reaching 93.88% in the elderly group, only slightly lower than among younger patients (97.18%). CONCLUSION PTCA is a technique particularly indicated in the elderly in Alsace because of regional geographic and medical specificities: nearby emergency services are available to virtually the entire population of Alsace, and most interventional cardiology teams apply a strategy of exclusive primary PTCA.
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Affiliation(s)
- G Dangelser
- USIC, Groupe hospitalier privé du Centre Alsace, Clinique Saint-Joseph, Colmar.
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Gottwalles Y, Dangelser G, De Poli F, Mathien C, Levai L, Boulenc JM, Monassier JP, Jacquemin L, El Belghiti R, Couppie P, Hanssen M. [Acute STEMI in old and very old patients. The real life]. Ann Cardiol Angeiol (Paris) 2004; 53:305-13. [PMID: 15603172 DOI: 10.1016/j.ancard.2004.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
OBJECTIVES From a prospective multicenter registry, we evaluated in three non-academic interventional cardiologic centers (Alsace/France), the coverage and the feasibility of the percutaneous coronary angioplasty (PTCA) in the acute phase of STEMI in the elderly (patients 75-years old and more). METHODS We studied clinical characteristics and angiographic data of patients older than 75 years, and the PTCA results: the revascularisation rates and the intrahospital events were analysed. These data were compared with those of the younger patients and confronted with the literature data. RESULTS Of a total of 1672 patients admitted for a STEMI, 342 (20.45%) were older than 75 years. These patients represented a high-risk group with a high proportion of women (50%), and many co-morbidities (e.g.: hypertension and diabetes mellitus), and three-vessel disease was found more often than in younger patients. Mortality rate was high in this subgroup and always more severe as compared to younger subjects, but remains variable according to the initial clinical profile. The global mortality was 20.47% but fell to 5.41% if we excluded the patients with cardiogenic shock, in Killip III and after resuscitation. PTCA is a coronary reperfusion technique particularly indicated in the management of the elderly presenting a STEMI. It is an effective technique in term of revascularisation, the reperfusion success (exclusively TIMI III flow) was indeed raised in the elderly even though it is lower than in younger patients (93.88 vs 97.18%). It is a quickly accessible technique, cath-lab accessibility provided, allowing a fast reperfusion and reducing hospitalization to a minimum. The management of the elderly presenting a STEMI has to focus on reducing the preadmission delay since this subgroup of patients hesitates to call the emergency (SMUR) when presenting an acute coronary symptomatology. The shorter the delay till admittance, the better the outcome. CONCLUSION PTCA is a technique particularly indicated in the elderly in Alsace because of regional specificities: first of all geographic (proximity of the SMUR for virtually all the population of Alsace), and secondly the medical infrastructure since the strategy of exclusive primary PTCA is granted by numerous interventional cardiologic teams. In Alsace, the proportion of elderly patients (> or = 75 years) is going to increase significantly with a parallel rise of STEMI--"a frightening perspective". We have to take into account this evolution, this reperfusion technique presenting numerous advantages and very few complications.
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Affiliation(s)
- Y Gottwalles
- USIC, Groupe hospitalier privé du Centre Alsace, clinique Saint-Joseph, 16, rue Roesselmann, 68003 Colmar cedex, France.
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