Clinical investigations: interventional cardiologyImpact of ST-segment resolution after primary angioplasty on outcomes after myocardial infarction in elderly patients: an analysis from the CADILLAC trial☆
Section snippets
Methods
The details of the CADILLAC trial protocol have been published previously.18 In brief, 2082 patients were enrolled in 76 centers in 9 countries between November 1997 and September 1999. The inclusion criteria were age >18 years (with no upper limit), presence of at least 30 minutes but <12 hours of symptoms consistent with AMI, and presence of ST-segment elevation in at least 2 contiguous leads or new left bundle-branch block. Patients with other electrocardiographic patterns were enrolled when
Results
A total of 695 patients with AMI and serial interpretable ST-segment analyses within the appropriate time frame were included in the STR substudy. The clinical characteristics of the study population stratified by age are summarized in Table I. Patients in the older age groups were more likely to be women, had a higher prevalence of hypertension and diabetes mellitus, and were less likely to be current smokers. Increasing age was also associated with a greater likelihood of congestive heart
Discussion
This study suggests that increasing age is not associated with lower rates of STR after primary PCI for AMI. Thus, adverse outcomes in elderly patients are unrelated to the primary PCI procedure itself, and lack of myocardial reperfusion is not the predominant mechanism responsible for the increasing morbidity and mortality rates. This thus strengthens the argument that advanced age is not a contraindication for primary PCI and may be the preferred management approach to AMI. In addition,
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2016, Medicina (Lithuania)Citation Excerpt :In our study we found that patients’ age, infarct duration, localization and epicardial blood flow after PPCI were important associates of myocardium damage reflected by STR. Previous studies of STR after PPCI for patients with STEMI did not find statistically significant association between patients’ age and STR [4,11,12]. Yet, one of the associates of incomplete STR in our study was higher patients’ age.
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Guest Editor for this manuscript was Frank Aquirre, MD, Prairie Cardiovascular Consultants, Ltd, Springfield, Ill.