虚弱对接受 PCI 治疗的 NSTEMI 老年患者预后的影响。

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS
Marco Mele MD , Ilaria Ragnatela MD , Matteo Romano MD , Erika Tabella MD , Luciano Umberto Rossi MD , Francesco Mautone MD , Antonietta Mele MD , Antonella Liantonio MD , Paola Imbrici MD , Michele Correale MD, PhD , Francesco Santoro MD, PhD , Natale Daniele Brunetti MD, PhD
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引用次数: 0

摘要

导言:体弱与较差的临床预后有关,体弱患者即使接受经皮冠状动脉介入治疗(PCI),其血管再通率也较低。因此,我们试图评估体弱对接受 PCI 治疗的非 ST 段抬高急性心肌梗死(NSTEMI)老年患者临床预后的影响:我们前瞻性地招募了 141 名连续入院的 NSTEMI 老年患者(年龄大于 75 岁)。104名患者接受了PCI治疗(35名体弱者,69名非体弱者),37名患者未接受血管重建治疗(22名体弱者,15名非体弱者):结果:体弱患者年龄较大,男性患者较少,痴呆症和严重左心室功能障碍患者较多,接受 PCI 治疗的患者较少;接受 PCI 治疗的患者较年轻,痴呆症患者较少。接受PCI治疗的非体弱患者的30天死亡率从3%上升到7%,接受PCI治疗的体弱患者的死亡率为17%,未接受PCI治疗的体弱患者的死亡率为48%(P,结论):在一项针对老年 NSTEMI 患者的观察性研究中,体弱与较差的预后有关,而 PCI 与较好的长期预后有关。谨慎选择适合进行 PCI 血管再通的患者可能有助于改善 NSTEMI 老年体弱患者的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of Frailty on Outcome of Older Patients With Non-ST Elevation Acute Myocardial Infarction Who Undergo Percutaneous Coronary Intervention

Frailty status is linked with a poorer clinical outcome, and patients with frailty are often less revascularized, even with percutaneous coronary intervention (PCI). We therefore sought to assess the impact of frailty on the clinical outcome of older patients with non-ST elevation acute myocardial infarction (NSTEMI) who underwent PCI. We prospectively enrolled 141 consecutive older patients (>75 years) admitted for NSTEMI; 104 patients underwent PCI (35 with frailty, 69 without frailty), and 37 were not revascularized (22 with frailty, 15 without). Patients with frailty were older, less frequently male, more affected by dementia and severe left ventricular dysfunction, and less treated with PCI; patients treated with PCI were younger and less affected by dementia. Thirty-day mortality rates were proportionally higher, from 3% in patients without frailty treated with PCI, to 7% in patients without frailty not treated with PCI, 17% in patients with frailty treated with PCI, and 48% in patients with frailty not treated with PCI (p <0.05). Similarly, 6-month mortality rates were proportionally higher (12%, 29%, 37%, and 71%). At multivariable analysis, frail status was associated to a sixfold increased risk of mortality at 30 days; at 6 months, frail status was associated to a 3.4-fold risk of death (p <0.01), but PCI was also associated to a lower risk of mortality (odds ratio 0.2, p <0.01). In an observational study in older patients with NSTEMI, frail status is associated to a poorer outcome, whereas PCI is associated to a better long-term outcome. A careful selection of patient suitable for revascularization by PCI may be useful in improving outcomes of older patients with frailty with NSTEMI.

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来源期刊
ACS Applied Bio Materials
ACS Applied Bio Materials Chemistry-Chemistry (all)
CiteScore
9.40
自引率
2.10%
发文量
464
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