Coronary angioplasty reduced three-year mortality compared to conservative treatment (25.9% vs 70.1%) in patients aged ≥75 years with acute myocardial infarction.
Observational
Does coronary angioplasty reduce mortality in elderly patients aged 75 years and older with acute myocardial infarction compared to conservative treatment?
Routine coronary angioplasty significantly reduces long-term mortality in patients aged 75 and older with acute myocardial infarction compared to conservative management, supporting non-selective invasive strategies in this demographic.
Absolute Event Rate: 25.9% vs 70.1%
The purpose of this study was to perform a comparative analysis of mortality and rehabilitation rates with three-year follow-up in patients with acute myocardial infarction in different age groups and to analyze the correlations of the above mentioned indicators with comorbid diseases. The results of our study show that coronary angioplasty is associated with the reduction of mortality in the elderly population compared with the conservative treatment at a three-year follow-up (25.9%; 70.1%). However, re-hospitalizations were comparable in the group of patients undergoing coronary angioplasty and in the group of conservative treatment (41.4%; 44.3%). It should be mentioned that in both groups, the average age of patients and the frequency of comorbid diseases were comparable. The treatment of myocardial infarction in elderly patients has a problematic approach, due to the difficulties of diagnosis, the presence of comorbid diseases, and the high likelihood of drug side effects. Numerous studies have shown that cardiac catheterization in case of acute myocardial infarction may be associated with high mortality in the elderly population. Although international guidelines recommend a routine invasive treatment approach, our study included elderly patients with myocardial infarction aged 75 years and older, for whom the effectiveness of an interventional approach was proven with long-term follow-up. Routine invasive intervention reduces mortality in elderly patients with myocardial infarction during a three-year follow-up. The results of the study confirm that the implementation of an interventional approach should not be selective in elderly patients. It should be mentioned that the age of a patient should not be a contraindication for a routine invasive intervention. A comprehensive clinical assessment of the condition of patients may have a more decisive role for choosing the tactics of conservative or interventional treatment in case of elderly patients with myocardial infarction.
Ռափյան et al. (Sun,) conducted a observational in Acute myocardial infarction. Coronary angioplasty vs. Conservative treatment was evaluated on Mortality at three-year follow-up. Coronary angioplasty reduced three-year mortality compared to conservative treatment (25.9% vs 70.1%) in patients aged ≥75 years with acute myocardial infarction.
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