التفاصيل البيبلوغرافية
| العنوان: |
Mitral Regurgitation and Prognosis After Non‐ST‐Segment Elevation Myocardial Infarction in Very Old Patients. |
| المؤلفون: |
Díez‐Villanueva, Pablo, Vera, Alberto, Ariza‐Solé, Albert, Alegre, Oriol, Formiga, Francesc, López‐Palop, Ramon, Marín, Francisco, Vidán, María T., Martínez‐Sellés, Manuel, Salamanca, Jorge, Sionis, Alessandro, García‐Pardo, Héctor, Bueno, Héctor, Sanchís, Juan, Abu‐Assi, Emad, González‐Salvado, Violeta, Llaó, Isaac, Alfonso, Fernando |
| المصدر: |
Journal of the American Geriatrics Society; Aug2019, Vol. 67 Issue 8, p1641-1648, 8p, 4 Charts, 1 Graph |
| مصطلحات موضوعية: |
MITRAL valve insufficiency, MYOCARDIAL infarction, PROGNOSIS, DISEASES in older people, HOSPITAL mortality, PATIENT readmissions, ECHOCARDIOGRAPHY, FRAIL elderly, MYOCARDIAL infarction diagnosis, MALNUTRITION risk factors, AGE factors in disease, ATRIAL fibrillation, BLOOD pressure, CONFIDENCE intervals, FUNCTIONAL assessment, HEALTH status indicators, HEART beat, LENGTH of stay in hospitals, HOSPITAL admission & discharge, LONGITUDINAL method, MEDICAL cooperation, PATIENTS, PROBABILITY theory, RESEARCH, SYMPTOMS, ODDS ratio, VENTRICULAR ejection fraction, OLD age |
| مستخلص: |
Background/Objetctives: Mitral regurgitation (MR)after an acute coronary syndrome is associated with a poor prognosis. However,the prognostic impact of MR in elderly patients with non‐ST‐segment elevation myocardialinfarction (NSTEMI) has not been well addressed. Design: Prospective registry. Setting and participants: The multicenter LONGEVO‐SCA prospective registry included 532 unselected NSTEMI patients aged ≥80 years. Measurements: MR was quantified using echocardiography during admission in 497 patients. They were classified in two groups: significant (moderate or severe) or not significant MR (absent or mild). We evaluated the impact of MR status on mortality or readmission at 6 months. Results: Mean age was 84.3±4.1 years, and 308 (61.9%) were males. A total of 108 patients (21.7%) had significant MR. Compared with those without significant MR, they were older and showed worse baseline clinical status, with higher frailty, disability, and risk of malnutrition. They also had lower systolic blood pressure, higher heart rate, worse Killip class, lower left ventricular ejection fraction, and higher pulmonary pressure on admission, as well as more often new onset atrial fibrillation (all p values = 0.001). Patients with significant MR also had higher in‐hospital mortality (4.6% vs. 1.3%, p = 0.04), longer hospital stay (median 8 [5‐12] vs. 6 [4‐10] days, p = 0.002), and higher mortality/readmission at 6 months (hazard ratio 1.54, 95% confidence interval 1.09‐2.18, p = 0.015). However, after adjusting for potential confounders, this last association was not significant. Conclusions: Significant MR is seen in one fifth of octogenarians with NSTEMI. Patients with significant MR have a poor prognosis, mainly determined by their baseline clinical characteristics. J Am Geriatr Soc 67:1641–1648, 2019 [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
