Coronary Artery DiseaseManagement of Patients Aged ≥85 Years With ST-Elevation Myocardial Infarction
Section snippets
Methods
The cohort studied included consecutive patients aged ≥85 years who presented with STEMI to Austin Health from November 2011 to July 2015. Austin Health is a large metropolitan tertiary hospital affiliated with the University of Melbourne; it services a population of approximately 1.25 million people.
Scrutiny of coding data identified patients aged ≥85 years with a diagnosis of STEMI (International Classification of Disease [ICD] 10 code I21.3). A manual chart review was performed to confirm
Results
A total of 115 patients aged ≥85 years were assigned the ICD 10 code I21.3 for STEMI. Of these patients, 2 (1.7%) were excluded as they were transferred from the emergency department to another institution. A further 12 patients (10.6%) were excluded as their electrocardiogram and/or clinical history did not meet criteria for an STEMI. Of the remaining 101 patients included in our analysis, 56 (55%) were managed conservatively and 45 (45%) received invasive management. Follow-up data were
Discussion
In this cohort of patients aged ≥85 years who were treated at the discretion of their physicians, those managed invasively were younger with greater functional and cognitive status and had a lower combined Charlson age-comorbidity index score. Markers of increased risk including age, anterior STEMI, and cognitive impairment were independently associated with a decision for conservative management. Patients selected for invasive management exhibited improved survival rates in-hospital and during
Disclosures
The authors have no conflicts of interest to disclose.
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Cited by (0)
Drs. Matias Yudi and Nicholas Jones contributed equally to this manuscript.
Dr. Yudi is supported by a combined National Health and Medical Research Council (NHMRC) and National Heart Foundation Postgraduate Scholarship (Australia).
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