Seniors Less Likely to Receive or Have Timely PCI for Acute MI
Patients >65 years of age have increased incidence of cardiac arrest, in-hospital mortality
MONDAY, April 8, 2019 (HealthDay News) -- Seniors with acute myocardial infarction (AMI) are less likely to undergo percutaneous coronary intervention (PCI) or receive PCI in a timely manner, according to a study presented at the American Heart Association Quality of Care and Outcomes Research 2019 Scientific Sessions, held from April 5 to 6 in Arlington, Virginia.
Wojciech Rzechorzek, M.D., from the Mount Sinai St. Luke's Hospital in New York City, and colleagues conducted a retrospective study using the 2014 Nationwide Inpatient Sample to examine outcomes and the therapeutic approach for 115,042 patients with AMI (54 percent aged >65 years).
The researchers found that the likelihood of receiving a PCI, including angioplasty and stent placement, was lower for patients >65 years of age (odds ratios, 0.66 and 0.64 for angioplasty and stent placement, respectively), and these patients had less timely stent implantation (odds ratio, 0.66 for stent within 48 hours). No difference was seen in utilization of thrombolysis and coronary artery bypass graft surgeries. Incidences of cardiac arrest and in-hospital mortality were increased for patients >65 years of age with AMI (odds ratios, 1.21 and 2.32, respectively). The likelihoods of going into shock, developing heart failure, or requiring mechanical ventilation were increased for patients >65 years of age (odds ratios, 1.28, 1.62, and 1.15, respectively). Length of stay was increased, but total changes were similar for patients >65 years of age.
"Elderly patients are underrepresented in clinical trials, and we need more prospective studies evaluating the impact of PCI on outcomes," Rzechorzek said in a statement.