Percutaneous coronary intervention reduces mortality in myocardial infarction patients with comorbidities: Implications for elderly patients with diabetes or kidney disease

Dégano, Irene R.; Subirana Cachinero, Isaac; Fusco, Danilo; Tavazzi, Luigi; Kirchberger, Inge; Farmakis, Dimitrios; Ferrières, Jean; Azevedo, Ana; Torre, Marina; Garel, Pascal; Brosa Riestra, Max; Davoli, Marina; Meisinger, Christa; Bongard, Vanina; Araújo, Carla; Lekakis, John; Francés, Albert; Castell, Conxa; Elosua Llanos, Roberto; Marrugat de la Iglesia, Jaume; EUROTRACS  investigators

Percutaneous coronary intervention reduces mortality in myocardial infarction patients with comorbidities: Implications for elderly patients with diabetes or kidney disease

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dc.contributor.author Dégano, Irene R.ca
dc.contributor.author Subirana Cachinero, Isaacca
dc.contributor.author Fusco, Daniloca
dc.contributor.author Tavazzi, Luigica
dc.contributor.author Kirchberger, Ingeca
dc.contributor.author Farmakis, Dimitriosca
dc.contributor.author Ferrières, Jeanca
dc.contributor.author Azevedo, Anaca
dc.contributor.author Torre, Marinaca
dc.contributor.author Garel, Pascalca
dc.contributor.author Brosa Riestra, Maxca
dc.contributor.author Davoli, Marinaca
dc.contributor.author Meisinger, Christaca
dc.contributor.author Bongard, Vaninaca
dc.contributor.author Araújo, Carlaca
dc.contributor.author Lekakis, Johnca
dc.contributor.author Francés, Albertca
dc.contributor.author Castell, Conxaca
dc.contributor.author Elosua Llanos, Robertoca
dc.contributor.author Marrugat de la Iglesia, Jaumeca
dc.contributor.author EUROTRACS investigatorsca
dc.date.accessioned 2018-06-05T07:18:42Z
dc.date.available 2018-06-05T07:18:42Z
dc.date.issued 2017
dc.description.abstract BACKGROUND: Percutaneous coronary intervention (PCI) reduces mortality in most myocardial infarction (MI) patients but the effect on elderly patients with comorbidities is unclear. Our aim was to analyse the effect of PCI on in-hospital mortality of MI patients, by age, sex, ST elevation on presentation, diabetes mellitus (DM) and chronic kidney disease (CKD). METHODS: Cohort study of 79,791 MI patients admitted at European hospitals during 2000-2014. The effect of PCI on in-hospital mortality was analysed by age group (18-74, ≥75years), sex, presence of ST elevation, DM and CKD, using propensity score matching. The number needed to treat (NNT) to prevent a fatal event was calculated. Sensitivity analyses were conducted. RESULTS: PCI was associated with lower in-hospital mortality in ST and non-ST elevation MI (STEMI and NSTEMI) patients. The effect was stronger in men [Odds ratio (95% confidence interval) 0.30 (0.25-0.35)] than in women [0.46 (0.39-0.54)] aged ≥75years, and in NSTEMI [0.22 (0.17-0.28)] than in STEMI patients [0.40 (0.31-0.5)] aged <75years. PCI reduced in-hospital mortality risk in patients with and without DM or CKD (54-72% and 52-73% reduction in DM and CKD patients, respectively). NNT was lower in patients with than without CKD [≥75years: STEMI=6(5-8) vs 9(8-10); NSTEMI=10(8-13) vs 16(14-20)]. Sensitivity analyses such as exclusion of hospital stays <2days yielded similar results. CONCLUSIONS: PCI decreased in-hospital mortality in MI patients regardless of age, sex, and presence of ST elevation, DM and CKD. This supports the recommendation for PCI in elderly patients with DM or CKD.
dc.format.mimetype application/pdf
dc.identifier.citation Dégano IR, Subirana I, Fusco D, Tavazzi L, Kirchberger I, Farmakis D. et al. Percutaneous coronary intervention reduces mortality in myocardial infarction patients with comorbidities: Implications for elderly patients with diabetes or kidney disease. Int J Cardiol. 2017 Dec 15;249:83-89. DOI: 10.1016/j.ijcard.2017.07.054
dc.identifier.doi http://dx.doi.org/10.1016/j.ijcard.2017.07.054
dc.identifier.issn 0167-5273
dc.identifier.uri http://hdl.handle.net/10230/34821
dc.language.iso eng
dc.publisher Elsevierca
dc.relation.ispartof International Journal of Cardiology. 2017 Dec 15;249:83-9
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject.keyword Chronic kidney disease
dc.subject.keyword Diabetes mellitus
dc.subject.keyword Elderly
dc.subject.keyword Myocardial infarction
dc.subject.keyword Percutaneous coronary intervention
dc.subject.other Ronyons -- Malalties
dc.subject.other Diabetis -- Complicacions
dc.subject.other Infart de miocardi
dc.subject.other Persones grans
dc.title Percutaneous coronary intervention reduces mortality in myocardial infarction patients with comorbidities: Implications for elderly patients with diabetes or kidney diseaseca
dc.type info:eu-repo/semantics/article
dc.type.version info:eu-repo/semantics/publishedVersion

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