scholarly journals Effects of atorvastatin combined with bivalirudin on coagulation function, cardiac function, and inflammatory factors of percutaneous coronary intervention in elderly patients with acute myocardial infarction

2020 ◽  
Vol 9 (4) ◽  
pp. 1905-1911
Author(s):  
Shenghua Ding ◽  
Shaopeng Xu ◽  
Xiaoning Chen ◽  
Shujuan Wu
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Elderly Patients ◽  
Cardiac Function ◽  
Coronary Intervention ◽  
Inflammatory Factors ◽  
Coagulation Function ◽  
Percutaneous Coronary

Impact of frailty on outcomes in elderly patients with acute myocardial infarction who undergo percutaneous coronary intervention

2020 ◽  
Author(s):  
Kensaku Nishihira ◽  
Goro Yoshioka ◽  
Nehiro Kuriyama ◽  
Kenji Ogata ◽  
Toshiyuki Kimura ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Elderly Patients ◽  
Major Bleeding ◽  
Coronary Intervention ◽  
Hospital Death ◽  
Killip Class ◽  
Frail Patients ◽  
Percutaneous Coronary

Abstract Aims  Frailty is characterized by reduced biological reserves and weakened resistance to stressors, and is common in older adults. This study evaluated the prognostic implications of frailty at hospitalization in elderly patients with acute myocardial infarction (AMI) who undergo percutaneous coronary intervention (PCI). Methods and results  We prospectively analysed 546 AMI patients aged ≥80 years undergoing PCI from 2009 to 2017. Frailty was classified based on impairment in walking (unassisted, assisted, and wheelchair/non-ambulatory), cognition (normal, mildly impaired, moderately to severely impaired), and basic activities of daily living. Impairment in each domain was scored as 0, 1, or 2, and patients were categorized into the following three groups based on total score: no frailty (0), mild frailty (1–2), moderate-to-severe frailty (≥3). The median follow-up period was 589 days. Of the 546 patients, 27.8% were frail (mild or moderate-to-severe), and this proportion significantly increased to 35.5% at discharge (P < 0.001). Compared to non-frail patients, frail patients were older, less likely to be male, and had a higher rate of advanced Killip class. Major bleeding (no frailty, 9.6%; mild frailty, 16.9%; moderate-to-severe frailty, 31.8%; P < 0.001) and in-hospital mortality (no frailty, 8.4%; mild frailty, 15.4%; moderate-to-severe frailty, 27.3%; P < 0.001) increased as frailty worsened. After adjusting for confounders, frailty was independently associated with higher mid-term all-cause mortality (hazard ratio, 1.81; 95% confidence interval, 1.23–2.65; P = 0.002). Conclusion  Frailty in AMI patients aged ≥80 years undergoing PCI was associated with major bleeding, in-hospital death, and mid-term mortality.

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