Prognosis of PCI in AMI setting in the elderly population: Outcomes from the multicenter prospective e‐ULTIMASTER registry
Background Elderly patients with ST‐elevation myocardial infarction (STEMI) who undergo percutaneous coronary intervention (PCI) are usually excluded from major trials. Hyopthesis This study sought to assess 1‐year clinical outcomes following PCI with a drug‐eluting stent in patients older than 80 y...
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| Veröffentlicht in: | Clinical cardiology (Mahwah, N.J.) N.J.), 2022-12, Vol.45 (12), p.1211-1219 |
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| creator | Saada, Majdi Kobo, Ofer Polad, Jawed Halabi, Majdi IJsselmuiden, Alexander J. J. Puentes, Ángel Monségu, Jacques Austin, David Baisebenov, Ruslan K. Spanó, Fabrizio Roguin, Ariel |
| description | Background
Elderly patients with ST‐elevation myocardial infarction (STEMI) who undergo percutaneous coronary intervention (PCI) are usually excluded from major trials.
Hyopthesis
This study sought to assess 1‐year clinical outcomes following PCI with a drug‐eluting stent in patients older than 80 years old with STEMI.
Methods
The large all‐comer, multicontinental e‐ULTIMASTER registry included 7507 patients with STEMI who underwent PCI using the Ultimaster stent. The primary clinical endpoint was 1‐year target lesion failure, a composite of cardiac death (CD), target vessel‐related myocardial infarction (TV‐MI), or clinically driven target lesion revascularization (CD‐TLR).
Results
There were 457 (6.1%) patients in the elderly group (≥80 years old) that were compared to 7050 (93.9%) patients |
| doi_str_mv | 10.1002/clc.23902 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9748751</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A740939591</galeid><sourcerecordid>A740939591</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5102-e1c16a8e00eb2332735572628a0449b4776c5d708b9b525f293619cf56568e253</originalsourceid><addsrcrecordid>eNp1ks1u1DAUhSMEokNhwQsgS2xgkal_4jhmgTSKCow0VSuYrq3EczN1ldjBTopG6qKPwDPyJDidUigCeWHZ_u45vlcnSV4SPCcY0yPd6jllEtNHyYxIRtNCMPE4mWGS41TSQh4kz0K4jCguKHuaHLAcCyqlnCXXZ95trQsmINegs3KJjEWLkyUKMAzGbqfjcAEI2g34dod6149tNRhn36HTcdCug4Aa77pbqhvbwWiwA3jUexd60IO5itU_br6fr9bLk8WX9fFn5GFrwuB3z5MnTdUGeHG3HybnH47X5ad0dfpxWS5WqeYE0xSIJnlVAMZQU8aoYJwLmtOiwlkm60yIXPONwEUta055QyXLidQNz3leAOXsMHm_1-3HuoPN9EFftar3pqv8TrnKqIcv1lyorbtSUmSF4CQKvLkT8O7rCGFQnQka2ray4MagqCCkyHBOJq_Xf6GXbvQ2thcpzqTgBRa_qW3VgjK2cdFXT6JqITIsmeRysp3_g4prA53RzkJj4v2Dgrf7Ah2HHzw09z0SrKaoqBgVdRuVyL76cyj35K9sROBoD3yLLrv_K6lyVe4lfwKlLcb3</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2753975807</pqid></control><display><type>article</type><title>Prognosis of PCI in AMI setting in the elderly population: Outcomes from the multicenter prospective e‐ULTIMASTER registry</title><source>Wiley Online Library</source><source>Wiley Online Library Open Access</source><source>DOAJ Directory of Open Access Journals</source><source>PubMed Central</source><source>EZB Electronic Journals Library</source><creator>Saada, Majdi ; Kobo, Ofer ; Polad, Jawed ; Halabi, Majdi ; IJsselmuiden, Alexander J. J. ; Puentes, Ángel ; Monségu, Jacques ; Austin, David ; Baisebenov, Ruslan K. ; Spanó, Fabrizio ; Roguin, Ariel</creator><creatorcontrib>Saada, Majdi ; Kobo, Ofer ; Polad, Jawed ; Halabi, Majdi ; IJsselmuiden, Alexander J. J. ; Puentes, Ángel ; Monségu, Jacques ; Austin, David ; Baisebenov, Ruslan K. ; Spanó, Fabrizio ; Roguin, Ariel ; e-ULTIMASTER Investigators ; e‐ULTIMASTER Investigators</creatorcontrib><description>Background
Elderly patients with ST‐elevation myocardial infarction (STEMI) who undergo percutaneous coronary intervention (PCI) are usually excluded from major trials.
Hyopthesis
This study sought to assess 1‐year clinical outcomes following PCI with a drug‐eluting stent in patients older than 80 years old with STEMI.
Methods
The large all‐comer, multicontinental e‐ULTIMASTER registry included 7507 patients with STEMI who underwent PCI using the Ultimaster stent. The primary clinical endpoint was 1‐year target lesion failure, a composite of cardiac death (CD), target vessel‐related myocardial infarction (TV‐MI), or clinically driven target lesion revascularization (CD‐TLR).
Results
There were 457 (6.1%) patients in the elderly group (≥80 years old) that were compared to 7050 (93.9%) patients <80 years. The elderly patients included more female patients and had significantly more comorbidities and had more complex coronary anatomy. The primary endpoint occurred in 7.2% of the elderly, compared to 3.1% of the younger group (p < .001). All‐cause mortality was significantly higher among the elderly group compared to the younger group (10.1% vs. 2.3%, p < .0001), as well as CD (6.1% vs. 1.6%, p < .0001), but not TV‐MI (1.1% vs. 0.7%, p = .34) or CD‐TLR (1.1% vs. 1.4%, p = .63).
Conclusion
Elderly patients with STEMI presentation had a higher incidence of the composite endpoint than younger patients. All‐cause and CD were higher for elderly patients compared to patients younger than 80 years old. However, there was no difference in the incidence of TV‐MI or target lesion revascularizations. These findings suggest that PCI for STEMI in elderly patients is relatively safe.</description><identifier>ISSN: 0160-9289</identifier><identifier>EISSN: 1932-8737</identifier><identifier>DOI: 10.1002/clc.23902</identifier><identifier>PMID: 36072999</identifier><language>eng</language><publisher>United States: John Wiley & Sons, Inc</publisher><subject>Age ; Aged patients ; Angioplasty ; Calcification ; Cardiac patients ; Cardiovascular disease ; Clinical Investigations ; Comparative analysis ; coronary artery disease ; Coronary vessels ; Diabetes ; elderly ; Heart ; Heart attack ; Heart attacks ; Heart surgery ; Hypertension ; Medical prognosis ; Mortality ; myocardial infarction ; Older people ; outcome ; Patient outcomes ; Patients ; Prognosis ; stent ; Stent (Surgery) ; Stents ; Transluminal angioplasty ; Vein & artery diseases</subject><ispartof>Clinical cardiology (Mahwah, N.J.), 2022-12, Vol.45 (12), p.1211-1219</ispartof><rights>2022 The Authors. published by Wiley Periodicals LLC.</rights><rights>2022 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.</rights><rights>COPYRIGHT 2022 John Wiley & Sons, Inc.</rights><rights>2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5102-e1c16a8e00eb2332735572628a0449b4776c5d708b9b525f293619cf56568e253</citedby><cites>FETCH-LOGICAL-c5102-e1c16a8e00eb2332735572628a0449b4776c5d708b9b525f293619cf56568e253</cites><orcidid>0000-0003-4628-1840</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9748751/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9748751/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,1411,11541,27901,27902,45550,45551,46027,46451,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36072999$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Saada, Majdi</creatorcontrib><creatorcontrib>Kobo, Ofer</creatorcontrib><creatorcontrib>Polad, Jawed</creatorcontrib><creatorcontrib>Halabi, Majdi</creatorcontrib><creatorcontrib>IJsselmuiden, Alexander J. J.</creatorcontrib><creatorcontrib>Puentes, Ángel</creatorcontrib><creatorcontrib>Monségu, Jacques</creatorcontrib><creatorcontrib>Austin, David</creatorcontrib><creatorcontrib>Baisebenov, Ruslan K.</creatorcontrib><creatorcontrib>Spanó, Fabrizio</creatorcontrib><creatorcontrib>Roguin, Ariel</creatorcontrib><creatorcontrib>e-ULTIMASTER Investigators</creatorcontrib><creatorcontrib>e‐ULTIMASTER Investigators</creatorcontrib><title>Prognosis of PCI in AMI setting in the elderly population: Outcomes from the multicenter prospective e‐ULTIMASTER registry</title><title>Clinical cardiology (Mahwah, N.J.)</title><addtitle>Clin Cardiol</addtitle><description>Background
Elderly patients with ST‐elevation myocardial infarction (STEMI) who undergo percutaneous coronary intervention (PCI) are usually excluded from major trials.
Hyopthesis
This study sought to assess 1‐year clinical outcomes following PCI with a drug‐eluting stent in patients older than 80 years old with STEMI.
Methods
The large all‐comer, multicontinental e‐ULTIMASTER registry included 7507 patients with STEMI who underwent PCI using the Ultimaster stent. The primary clinical endpoint was 1‐year target lesion failure, a composite of cardiac death (CD), target vessel‐related myocardial infarction (TV‐MI), or clinically driven target lesion revascularization (CD‐TLR).
Results
There were 457 (6.1%) patients in the elderly group (≥80 years old) that were compared to 7050 (93.9%) patients <80 years. The elderly patients included more female patients and had significantly more comorbidities and had more complex coronary anatomy. The primary endpoint occurred in 7.2% of the elderly, compared to 3.1% of the younger group (p < .001). All‐cause mortality was significantly higher among the elderly group compared to the younger group (10.1% vs. 2.3%, p < .0001), as well as CD (6.1% vs. 1.6%, p < .0001), but not TV‐MI (1.1% vs. 0.7%, p = .34) or CD‐TLR (1.1% vs. 1.4%, p = .63).
Conclusion
Elderly patients with STEMI presentation had a higher incidence of the composite endpoint than younger patients. All‐cause and CD were higher for elderly patients compared to patients younger than 80 years old. However, there was no difference in the incidence of TV‐MI or target lesion revascularizations. These findings suggest that PCI for STEMI in elderly patients is relatively safe.</description><subject>Age</subject><subject>Aged patients</subject><subject>Angioplasty</subject><subject>Calcification</subject><subject>Cardiac patients</subject><subject>Cardiovascular disease</subject><subject>Clinical Investigations</subject><subject>Comparative analysis</subject><subject>coronary artery disease</subject><subject>Coronary vessels</subject><subject>Diabetes</subject><subject>elderly</subject><subject>Heart</subject><subject>Heart attack</subject><subject>Heart attacks</subject><subject>Heart surgery</subject><subject>Hypertension</subject><subject>Medical prognosis</subject><subject>Mortality</subject><subject>myocardial infarction</subject><subject>Older people</subject><subject>outcome</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Prognosis</subject><subject>stent</subject><subject>Stent (Surgery)</subject><subject>Stents</subject><subject>Transluminal angioplasty</subject><subject>Vein & artery diseases</subject><issn>0160-9289</issn><issn>1932-8737</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>BENPR</sourceid><recordid>eNp1ks1u1DAUhSMEokNhwQsgS2xgkal_4jhmgTSKCow0VSuYrq3EczN1ldjBTopG6qKPwDPyJDidUigCeWHZ_u45vlcnSV4SPCcY0yPd6jllEtNHyYxIRtNCMPE4mWGS41TSQh4kz0K4jCguKHuaHLAcCyqlnCXXZ95trQsmINegs3KJjEWLkyUKMAzGbqfjcAEI2g34dod6149tNRhn36HTcdCug4Aa77pbqhvbwWiwA3jUexd60IO5itU_br6fr9bLk8WX9fFn5GFrwuB3z5MnTdUGeHG3HybnH47X5ad0dfpxWS5WqeYE0xSIJnlVAMZQU8aoYJwLmtOiwlkm60yIXPONwEUta055QyXLidQNz3leAOXsMHm_1-3HuoPN9EFftar3pqv8TrnKqIcv1lyorbtSUmSF4CQKvLkT8O7rCGFQnQka2ray4MagqCCkyHBOJq_Xf6GXbvQ2thcpzqTgBRa_qW3VgjK2cdFXT6JqITIsmeRysp3_g4prA53RzkJj4v2Dgrf7Ah2HHzw09z0SrKaoqBgVdRuVyL76cyj35K9sROBoD3yLLrv_K6lyVe4lfwKlLcb3</recordid><startdate>202212</startdate><enddate>202212</enddate><creator>Saada, Majdi</creator><creator>Kobo, Ofer</creator><creator>Polad, Jawed</creator><creator>Halabi, Majdi</creator><creator>IJsselmuiden, Alexander J. J.</creator><creator>Puentes, Ángel</creator><creator>Monségu, Jacques</creator><creator>Austin, David</creator><creator>Baisebenov, Ruslan K.</creator><creator>Spanó, Fabrizio</creator><creator>Roguin, Ariel</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-4628-1840</orcidid></search><sort><creationdate>202212</creationdate><title>Prognosis of PCI in AMI setting in the elderly population: Outcomes from the multicenter prospective e‐ULTIMASTER registry</title><author>Saada, Majdi ; Kobo, Ofer ; Polad, Jawed ; Halabi, Majdi ; IJsselmuiden, Alexander J. J. ; Puentes, Ángel ; Monségu, Jacques ; Austin, David ; Baisebenov, Ruslan K. ; Spanó, Fabrizio ; Roguin, Ariel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5102-e1c16a8e00eb2332735572628a0449b4776c5d708b9b525f293619cf56568e253</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Age</topic><topic>Aged patients</topic><topic>Angioplasty</topic><topic>Calcification</topic><topic>Cardiac patients</topic><topic>Cardiovascular disease</topic><topic>Clinical Investigations</topic><topic>Comparative analysis</topic><topic>coronary artery disease</topic><topic>Coronary vessels</topic><topic>Diabetes</topic><topic>elderly</topic><topic>Heart</topic><topic>Heart attack</topic><topic>Heart attacks</topic><topic>Heart surgery</topic><topic>Hypertension</topic><topic>Medical prognosis</topic><topic>Mortality</topic><topic>myocardial infarction</topic><topic>Older people</topic><topic>outcome</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Prognosis</topic><topic>stent</topic><topic>Stent (Surgery)</topic><topic>Stents</topic><topic>Transluminal angioplasty</topic><topic>Vein & artery diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Saada, Majdi</creatorcontrib><creatorcontrib>Kobo, Ofer</creatorcontrib><creatorcontrib>Polad, Jawed</creatorcontrib><creatorcontrib>Halabi, Majdi</creatorcontrib><creatorcontrib>IJsselmuiden, Alexander J. J.</creatorcontrib><creatorcontrib>Puentes, Ángel</creatorcontrib><creatorcontrib>Monségu, Jacques</creatorcontrib><creatorcontrib>Austin, David</creatorcontrib><creatorcontrib>Baisebenov, Ruslan K.</creatorcontrib><creatorcontrib>Spanó, Fabrizio</creatorcontrib><creatorcontrib>Roguin, Ariel</creatorcontrib><creatorcontrib>e-ULTIMASTER Investigators</creatorcontrib><creatorcontrib>e‐ULTIMASTER Investigators</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical cardiology (Mahwah, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Saada, Majdi</au><au>Kobo, Ofer</au><au>Polad, Jawed</au><au>Halabi, Majdi</au><au>IJsselmuiden, Alexander J. J.</au><au>Puentes, Ángel</au><au>Monségu, Jacques</au><au>Austin, David</au><au>Baisebenov, Ruslan K.</au><au>Spanó, Fabrizio</au><au>Roguin, Ariel</au><aucorp>e-ULTIMASTER Investigators</aucorp><aucorp>e‐ULTIMASTER Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognosis of PCI in AMI setting in the elderly population: Outcomes from the multicenter prospective e‐ULTIMASTER registry</atitle><jtitle>Clinical cardiology (Mahwah, N.J.)</jtitle><addtitle>Clin Cardiol</addtitle><date>2022-12</date><risdate>2022</risdate><volume>45</volume><issue>12</issue><spage>1211</spage><epage>1219</epage><pages>1211-1219</pages><issn>0160-9289</issn><eissn>1932-8737</eissn><abstract>Background
Elderly patients with ST‐elevation myocardial infarction (STEMI) who undergo percutaneous coronary intervention (PCI) are usually excluded from major trials.
Hyopthesis
This study sought to assess 1‐year clinical outcomes following PCI with a drug‐eluting stent in patients older than 80 years old with STEMI.
Methods
The large all‐comer, multicontinental e‐ULTIMASTER registry included 7507 patients with STEMI who underwent PCI using the Ultimaster stent. The primary clinical endpoint was 1‐year target lesion failure, a composite of cardiac death (CD), target vessel‐related myocardial infarction (TV‐MI), or clinically driven target lesion revascularization (CD‐TLR).
Results
There were 457 (6.1%) patients in the elderly group (≥80 years old) that were compared to 7050 (93.9%) patients <80 years. The elderly patients included more female patients and had significantly more comorbidities and had more complex coronary anatomy. The primary endpoint occurred in 7.2% of the elderly, compared to 3.1% of the younger group (p < .001). All‐cause mortality was significantly higher among the elderly group compared to the younger group (10.1% vs. 2.3%, p < .0001), as well as CD (6.1% vs. 1.6%, p < .0001), but not TV‐MI (1.1% vs. 0.7%, p = .34) or CD‐TLR (1.1% vs. 1.4%, p = .63).
Conclusion
Elderly patients with STEMI presentation had a higher incidence of the composite endpoint than younger patients. All‐cause and CD were higher for elderly patients compared to patients younger than 80 years old. However, there was no difference in the incidence of TV‐MI or target lesion revascularizations. These findings suggest that PCI for STEMI in elderly patients is relatively safe.</abstract><cop>United States</cop><pub>John Wiley & Sons, Inc</pub><pmid>36072999</pmid><doi>10.1002/clc.23902</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-4628-1840</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0160-9289 |
| ispartof | Clinical cardiology (Mahwah, N.J.), 2022-12, Vol.45 (12), p.1211-1219 |
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| source | Wiley Online Library; Wiley Online Library Open Access; DOAJ Directory of Open Access Journals; PubMed Central; EZB Electronic Journals Library |
| subjects | Age Aged patients Angioplasty Calcification Cardiac patients Cardiovascular disease Clinical Investigations Comparative analysis coronary artery disease Coronary vessels Diabetes elderly Heart Heart attack Heart attacks Heart surgery Hypertension Medical prognosis Mortality myocardial infarction Older people outcome Patient outcomes Patients Prognosis stent Stent (Surgery) Stents Transluminal angioplasty Vein & artery diseases |
| title | Prognosis of PCI in AMI setting in the elderly population: Outcomes from the multicenter prospective e‐ULTIMASTER registry |
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