Abstract:
AIM:The best reperfusion strategy for patients of advanced age (either primary-angioplasty or thrombolysis) after a ST-segment elevation myocardial infarction (STEMI) remains controversial. Aim of the study was to test differences in morbidity and mortality regarding the reperfusion strategy adopted. METHODS:From 2007-2012, 182 patients ≥85 year-old with STEMI were admitted to the coronary care unit of two tertiary centers. Data regarding baseline characteristics, clinical presentation, reperfusion strategy adopted and outcomes were retrospectively reviewed. The relation between the type of reperfusion therapy and outcomes was evaluated. RESULTS:Median age was 86.8±6.9 years (range 85-96). Most patients (54.4%) were woman. Anterior wall STEMI was the main electrocardiographic location (45.1%). A conservative treatment was seen in 64 patients (35.2%), thrombolysis in 41 (22.5%) and primary-angioplasty in the remaining 77 patients (42.3%). A total of 56 patients died (30.8%). The mortality rate in the thrombolysis group (21.9%) was similar than that found in the primary-angioplasty group (15.6%) (P=0.45). No difference was found in a subgroup analysis of high risk patients (i.e. anterior wall STEMI, Killip class ≥2). Morbidity rates were also similar between both therapeutic groups (thrombolisys 58.5% vs. primary-angioplasty 46.7%, P=0.22). Morbidity and mortality rates were much higher among those patients treated conservatively than that found in patients who received any of the reperfusion strategies (54.6% vs. 17.8%, P<0.0001 and 79.7% vs. 50.8%, P<0.0001, respectively). CONCLUSIONS:Mortality and morbidity among very elderly patients with STEMI are extremely high. No differences were found between primary-angioplasty and fibrinolysis with regard to outcomes. A conservative treatment was associated with a worse prognosis.
journal_name
Minerva Cardioangioljournal_title
Minerva cardioangiologicaauthors
Renilla A,Barreiro M,Díaz E,Rozado J,Barriales V,Moris Csubject
Has Abstractpub_date
2014-12-01 00:00:00pages
473-9issue
6eissn
0026-4725issn
1827-1618pii
R05Y2014N06A0473journal_volume
62pub_type
杂志文章abstract::With radioisotopes it is possible to study the heart obtaining complementary or substitutive informations to those provided by the most common noninvasive methods of myocardial assessment and by coronarography. This paper aim is to report experience with thallium 201 and 99mTc isonitrile in the diagnosis and followup ...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract::Deep venous thrombosis (DVT) is often difficult to diagnose based on objective data alone (sensitivity 60-66%, specificity 20-72%, according to a number of studies) and this leads to the possible misuse of instrumental tests. It is important to establish standard clinical protocols to select those cases that call for ...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:2000-12-01 00:00:00
abstract::Pulmonary thromboembolism is a relatively common disease in an Emergency Department. Diagnosis, often difficult, is based on careful evaluation of risk factors, clinical examination, radiological and laboratory investigations. Plasma D-dimer, a degradation product of cross-linked fibrin with low specificity and very h...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:2006-04-01 00:00:00
abstract::Cardiac mixoma in the elderly. A clinical study. The clinical features of 13 cardiac myxomas surgically resected are presented. The mean age at presentation was 68 years. Ten were in the left atrium, 5 near the fossa ovalis, 3 at the base of the atrial septum, 1 at the inferior wall and 1 on the anterior leaflet of mi...
journal_title:Minerva cardioangiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Ablation of ventricular tachycardia is the main therapy for patients with drug-refractory VT. Although evidence suggests that VT ablation could lower the incidence of recurrent VT, many cases still develop VT in follow-up. In this study, we performed a systematic review and meta-analysis to examine risk fact...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:10.23736/S0026-4725.20.05128-2
更新日期:2020-09-29 00:00:00
abstract::An aortic thrombus may be detected by using transesophageal echocardiography after an embolic event. Clinical features are variable and may include cardiac and neurologic symptoms, such as the stroke. We report a case of a woman with an acute ischemic stroke, a myocardial infarction and a free floating aortic thrombus...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:2006-12-01 00:00:00
abstract::Transcatheter aortic valve implantation (TAVI) is the treatment of choice among patients with symptomatic severe aortic stenosis (AS) deemed inoperable and a valuable alternative to surgical aortic valve replacement for high-risk surgical patients. Over the years, this procedure proved to be relatively safe, but despi...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章,评审
doi:
更新日期:2016-06-01 00:00:00
abstract::This paper presents a study of plethysmographic changes induced by methacholine (a derivative of acetylcholine) administered via iontophoresis in a population of 41 young women with apparently primary Raynaud's disease. All patients presented with a very clear statistically significant sphygmic increment, obviously co...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:2000-04-01 00:00:00
abstract::The clinical introduction of catheter ablation in 1981 revolutionized the treatment of cardiac arrhythmias. Implementation of radiofrequency as an alternative energy source, with the advantages of higher selectivity and less collateral damage, provided an expansion of catheter ablation therapy. Today the majority of a...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章,评审
doi:
更新日期:2002-06-01 00:00:00
abstract:OBJECTIVE:The proposal of this study is to compare the efficacy of lisinopril and theophylline, alone or in association, on erythrocytosis in renal-transplanted patients. DESIGN:Prospectic, case-control study. PATIENTS/ENVIRONMENT: 15 inpatients meeting 3 main criteria: 1) ACE therapy for past erythrocytosis, 2) actua...
journal_title:Minerva cardioangiologica
pub_type: 临床试验,杂志文章,评审
doi:
更新日期:1997-11-01 00:00:00
abstract::In the period 1972-1988, 209 patients (81 males, 128 females, mean age 42.4 +/- 11.9, range 20-71 years) underwent surgery for multiple valve repair (MVR) at the Italian Institution of Cardiac Surgery. Ninety-five patients had previously undergone mitral commissurotomy (MC). NTHA function class was III-IV in 89% of th...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:1994-06-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to define a correct anesthesiological and surgical approach in patient who present a significant carotid stenosis with contralateral carotid occlusion. METHODS:Between 1996 and 1998 in our Department of Vascular Surgery of the Hospital S. Giovanni Battista has been executed 337...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:1998-11-01 00:00:00
abstract::After the introduction of coronary balloon angioplasty, bare-metal, and drug-eluting stents, fully bioresorbable scaffolds (BRS) could be the fourth revolution in interventional cardiology. The BRS technology shares the advantages of metallic stents regarding acute gain and prevention of acute vessel occlusion by prov...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章,评审
doi:
更新日期:2013-04-01 00:00:00
abstract::The diagnosis of previous non-Q wave myocardial infarction by standard electrocardiographic investigation is uncertain, particularly in elderly patients because of concomitant disease. We have studied 31 elderly patients (aged 63-72 years) with a diagnosis of non-Q wave myocardial infarction between 1-6 months after t...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章,评审
doi:
更新日期:1995-01-01 00:00:00
abstract::In the present study we evaluated 35 patients of both sexes, aged 21-84, with newly occurring supraventricular tachyarrhythmias, 19 atrial fibrillation (AF), 6 atrial flutter (FL) and 10 paroxysmal supraventricular tachycardias (PSVT). They were treated with a single amiodarone infusion up to two hours after the resto...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:1991-03-01 00:00:00
abstract::Since its initial description by Gramiak and Shah in 1968, contrast echocardiography has become an established practice world-wide. Microbubbles have the unique property of being pure intravascular tracers. The basic rationale behind bubble imaging is the characteristic responses to ultrasound power that results in en...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章,评审
doi:
更新日期:2010-06-01 00:00:00
abstract::A patent ductus arteriosus in adults is a rare eventuality. After correct diagnosis, an accurate evaluation of pulmonary vascular resistances is necessary with, in case of normality, a straightforward indication to surgery, because the evolution of the disease cannot be predicted. In case of pulmonary hypertension irr...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:1991-09-01 00:00:00
abstract::Hypertension remains a major public health burden despite the plethora of therapeutic agents available for this disorder, compelling innovation of alternate therapies including interventional approaches where necessary. The kidney is a major player in the pathophysiology of this disease with increased sympathetic acti...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章,评审
doi:
更新日期:2014-02-01 00:00:00
abstract::Vasodilators represent one of the main steps for the medical treatment of pulmonary hypertension; the rationale for their use is the reversibility of the pulmonary vasoconstriction, to be tested with a correct pharmacological trial. In this report the authors consider the use of calcium-channel blockers, prostaglandin...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:1995-06-01 00:00:00
abstract:INTRODUCTION:An evaluation of the effects of statins on total mortality in the context of primary prevention was carried out, by means of the analysis of data taken from major clinical trials published in the literature. EVIDENCE ACQUISITION:Published systematic reviews were used to identify relevant clinical trials, ...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章,meta分析,评审
doi:10.23736/S0026-4725.17.04323-7
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Galectin-3 is a recently developed biomarker of fibrosis, which may play a role in cardiac remodeling and associated with both the progression and severity of heart failure (HF). METHODS:A prospective cohort study of 190 patients with documented prior myocardial infarction and chronic HF (NYHA class II-IV) ...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:2016-12-01 00:00:00
abstract::The decision to offer patients with myocardial ischemia a coronary artery bypass graft (CABG) surgery has been largely determined by extent of coronary artery disease (CAD) and left ventricular function, since the early 1970's. Based upon subset analyses, and long-term follow-up, of three moderate-sized trials of stab...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章,评审
doi:
更新日期:2006-10-01 00:00:00
abstract::Hypertrophic cardiomyopathy is a disease characterised by massive ventricular hypertrophy, reduced diastolic function and excessive ventricular contraction. It involves sections of both ventricles, but in particular the left ventricle. Although it was initially thought that this pathology might depend on a modified sy...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:1990-12-01 00:00:00
abstract::Cardiac hydatid disease represents 0.02-2% of the possible locations of the parasite. The case of an asymptomatic 60-year-old male patient, hospitalised for mnesic and cognitive disease, and with history of hepatic and pulmonary echinococcosis is reported. The patient showed a cardiac cyst localised in the mediobasal ...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:The aim of this study to investigate the correlation of the peripheral concentrations of one representative estrogen, E2 estradiol, with various indicators reflecting different aspects of cardiac structures and functions. METHODS:A total of 84 typical patients with hypertrophic cardiomyopathy (HCM) and 77 h...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:2016-08-01 00:00:00
abstract::Significant variations in the ECG have been observed in a female aged 77 with heart failure and chronic atrial fibrillation during an occasional increase in blood potassium followed by normalization. The major phenomena observed during hyperkalemia, due to a severe dehydration, were a transient sinus rhythm with atrio...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:1989-09-01 00:00:00
abstract::The search for the ideal antihypertensive drug is ongoing. Carvedilol is a new beta-adrenoceptor antagonist which also causes peripheral vasodilation primarily via alpha 1-adrenergic blockade. Twenty patients with mild to moderate essential hypertension and previous intolerance and side effects to other antihypertensi...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:1996-03-01 00:00:00
abstract:AIM:To evaluate any differences in ventricular pre-excitation secondary to Wolff Parkinson White syndrome in the aged compared to young and adult patients. METHODS: EXPERIMENTAL DESIGN:a clinical study was performed using a comparative prospective criterion with retrospective analysis. The duration of follow-up range...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章
doi:
更新日期:1998-12-01 00:00:00
abstract::The Impella left ventricular support system consists of two main components: a family of different ventricular support catheters with a microaxial pump to be placed across the aortic valve and a single external controller which is connected to activate and control the pump function. Four Impella left ventricular suppo...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章,评审
doi:10.23736/S0026-4725.18.04703-5
更新日期:2018-10-01 00:00:00
abstract::In presence of a patent foramen ovale (PFO) with cryptogenic cerebral embolism, traditional therapy consists of oral anticoagulation or antiplatelet therapy. Surgery was considered only in case of recurrence. Transcatheter closure of PFO is currently performed. The availability of new user friendly devices and the inc...
journal_title:Minerva cardioangiologica
pub_type: 杂志文章,评审
doi:
更新日期:2006-02-01 00:00:00