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Outcomes of early invasive treatment strategy in elderly patients with non-ST elevation acute coronary syndromes

Title: Outcomes of early invasive treatment strategy in elderly patients with non-ST elevation acute coronary syndromes
Authors: Conti E1; Musumeci MB; Desideri JP; VENTURA, MARCO; Fusco D; Zezza L; De Giusti M; Berni A; Francia P; Volpe M; Autore C.
Contributors: Conti, E1; Musumeci, Mb; Desideri, Jp; Ventura, Marco; Fusco, D; Zezza, L; De Giusti, M; Berni, A; Francia, P; Volpe, M; Autore, C.
Publication Year: 2016
Collection: Scuola Universitaria Superiore Pisa Sant'Anna: CINECA IRIS
Subject Terms: angioplasty; conservative treatment; elderly; invasive treatment; myocardial infarction; Acute Coronary Syndrome; Age Factor; Aged; 80 and over; Coronary Angiography; Coronary Artery Bypa; Female; Human; Italy; Male; Multivariate Analysi; Percutaneous Coronary Intervention; Regression Analysi; Retrospective Studie; Risk Assessment; Risk Factor; Time Factor; Treatment Outcome; Cardiology and Cardiovascular Medicine
Description: Background As benefits of revascularization in non-ST elevation acute coronary syndromes (NSTEACSs) in the elderly are still unproven, we sought to assess the association between invasive or conservative management of NSTEACS and short-, mid- and long-term mortality or composite outcome of all-cause mortality and myocardial infarction in a cohort of consecutive elderly patients. Methods and Results Consecutive NSTEACS patients older than 75 years discharged between 2006 and 2010 from a single intensive cardiac care unit, and managed with invasive or conservative strategy according to available guidelines were retrospectively surveyed. By multivariate regression and sensitivity analysis, crude and adjusted mortality and composite outcome were estimated at prespecified time points of short-term (in-hospital or 30 days mortality), mid-term (T1: 31 days to 6 months), and long-term (T2: 31 days to 12 months). A total of 453 patients (median age 80 years, 47% men) were evaluated; 301 (66.5%) underwent invasive treatment. Invasive was associated with significantly lower risk of short- [odds ratio (OR) 0.28, 95% confidence interval (CI) 0.12-0.67, PU0.004], mid- (OR 0.33, 95% CI 0.16-0.67, PU0.003) and long-term mortality (OR 0.34, 95% CI 0.20-0.58, P
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/wos/WOS:000383954800004; volume:17; issue:10; firstpage:736; lastpage:743; numberofpages:8; journal:JOURNAL OF CARDIOVASCULAR MEDICINE; http://hdl.handle.net/11382/524532; http://journals.lww.com/jcardiovascularmedicine
DOI: 10.2459/JCM.0000000000000364
Availability: http://hdl.handle.net/11382/524532; https://doi.org/10.2459/JCM.0000000000000364; http://journals.lww.com/jcardiovascularmedicine
Rights: info:eu-repo/semantics/openAccess
Accession Number: edsbas.AAF88732
Database: BASE