دورية أكاديمية
Changes in One-Year Mortality in Elderly Patients Admitted with Acute Myocardial Infarction in Relation with Early Management
| العنوان: | Changes in One-Year Mortality in Elderly Patients Admitted with Acute Myocardial Infarction in Relation with Early Management |
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| المؤلفون: | Puymirat, Etienne, Aissaoui, Nadia, Cayla, Guillaume, Lafont, Alexandre, Riant, Elisabeth, Mennuni, Marco, Saint-Jean, Olivier, Blanchard, Didier, Jourdain, Patrick, Elbaz, Meyer, Henry, Patrick, Bataille, Vincent, Drouet, Elodie, Mulak, Genevieve, Schiele, François, Ferrieres, Jean, Simon, Tabassome, Danchin, Nicolas, Investigators, Fast-Mi |
| المساهمون: | Service de cardiologie CHU HEGP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou APHP (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Paris Descartes - Paris 5 (UPD5), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de réanimation médicale CHU HEGP, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Université de Montpellier (UM), Humanitas Clinical and Research Center Rozzano, Milan, Italy, Hôpital Européen Georges Pompidou APHP (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Clinique Saint Gatien, Centre Hospitalier René Dubos Pontoise, Service Cardiologie CHU Toulouse, Pôle Cardiovasculaire et Métabolique CHU Toulouse, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hôpital Lariboisière, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal APHP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Saint-Antoine AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Pierre et Marie Curie - Paris 6 (UPMC), Hémostase, bio-ingénierie et remodelage cardiovasculaires (LBPC (U698)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut Galilée-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Société française de cardiologie, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon) |
| المصدر: | ISSN: 0002-9343. |
| بيانات النشر: | HAL CCSD Elsevier [Commercial Publisher] |
| سنة النشر: | 2017 |
| المجموعة: | Université Toulouse III - Paul Sabatier: HAL-UPS |
| مصطلحات موضوعية: | Mortality, Percutaneous coronary intervention, Acute myocardial infarction, Coronary angiography, Elderly, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology |
| الوصف: | International audience ; BACKGROUND:Elderly patients are underrepresented in acute myocardial infarction trials. Our aim was to determine whether, in elderly patients, changes in management in the past 15 years are associated with improved 1-year mortality after hospital admission for myocardial infarction.METHODS:We used data from 4 1-month French registries, conducted 5 years apart from 1995 to 2010, including 3389 elderly patients (≥75 years of age).RESULTS:From 1995 to 2010, mean age remained stable (82.1 years), similar in ST- and non-ST-elevation myocardial infarction patients. Obesity, diabetes, hypertension, and hypercholesterolemia increased. History of prior myocardial infarction, stroke, and peripheral artery disease remained stable, while history of heart failure decreased. Major changes in management were noted: early percutaneous coronary intervention, early treatment with antiplatelet agents, low-molecular-weight heparin, beta-blockers, angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, and statins all increased. Early mortality after hospital admission decreased from 25.0% to 8.4%. One-year mortality decreased from 36.2% to 20.0% (adjusted hazard ratio 2010 vs 1995: 0.47, 0.39-0.57), both for ST-elevation myocardial infarction (36.8% to 21.1%) and non-ST-elevation myocardial infarction (34.8% to 19.1%). Mortality reduction was observed in all age groups, including those ≥85 years of age (from 46.2% to 31.4%). The study period, however, was no longer associated with decreased mortality when variables reflecting management changes were taken into account.CONCLUSIONS:Early and 1-year mortality after hospital admission of elderly patients with acute myocardial infarction has substantially decreased over the past 15 years. This improvement is likely mediated by increasing use of recommended management strategies. These data support the application of guidelines derived from trials mostly including younger patients to elderly populations as well. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/28065766; hal-01897573; https://hal.science/hal-01897573Test; PUBMED: 28065766 |
| DOI: | 10.1016/j.amjmed.2016.12.005 |
| الإتاحة: | https://doi.org/10.1016/j.amjmed.2016.12.005Test https://hal.science/hal-01897573Test |
| رقم الانضمام: | edsbas.E9733918 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.amjmed.2016.12.005 |
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