Abstract:
AIMS:To explore variations in invasive care of the elderly with acute coronary syndromes across international practice. METHODS AND RESULTS:Using combined populations from the SYMPHONY and 2nd SYMPHONY trials, we describe 30-day cardiac catheterization in elderly (> or = 75 years; n = 1794) vs. younger patients (< 75 years; n = 14,043) after multivariable adjustment and by region of enrolment. The use of cardiac catheterization and revascularization were not protocol-specified. Elderly patients (median age 78 years) were more often female and more frequently had hypertension, diabetes, prior myocardial infarction, and prior coronary bypass surgery. Overall, they underwent less cardiac catheterization than younger patients [53 vs. 63%; adjusted OR 0.53 (0.46, 0.60)]. The absolute rate of cardiac catheterization in the elderly varied from 77% (vs. 91% in younger patients) in the US cohort to 27% (vs. 41% in younger patients) in the non-US cohort. Revascularization of elderly who underwent cardiac catheterization was also higher in US than non-US cohorts (71.3 vs. 53.6%). There was a significant interaction between the patient age and the use of catheterization across US and non-US regions of enrolment, as well as differences in the predictors of catheterization in the elderly. Despite these findings, after adjustment, 90-day rates of death and death or myocardial infarction (MI) were not significantly different in elderly who underwent catheterization compared with those who did not. CONCLUSION:Although older age is universally predictive of lower use of cardiac catheterization, marked variation in catheterization of the elderly exists across international practice. Demonstrated differences in patterns of use suggest a lack of consensus regarding optimal use of an invasive strategy in the elderly.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Alexander KP,Newby LK,Bhapkar MV,White HD,Hochman JS,Pfisterer ME,Moliterno DJ,Peterson ED,Van de Werf F,Armstrong PW,Califf RM,Symphony and 2nd Symphony Investigators.doi
10.1093/eurheartj/ehl067subject
Has Abstractpub_date
2006-07-01 00:00:00pages
1558-64issue
13eissn
0195-668Xissn
1522-9645pii
ehl067journal_volume
27pub_type
杂志文章,多中心研究abstract:AIMS:Inflammatory markers are established risk factors for atrial fibrillation (AF), but the role of autoimmune diseases is unknown. The aim of the study was to examine the association between coeliac disease (CD) and AF in a large cohort of patients with biopsy-verified CD. METHODS AND RESULTS:We identified 28,637 pa...
journal_title:European heart journal
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journal_title:European heart journal
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doi:10.1093/eurheartj/14.7.941
更新日期:1993-07-01 00:00:00
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journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2005-05-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:European heart journal
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doi:10.1093/eurheartj/ehy362
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journal_title:European heart journal
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更新日期:2014-12-14 00:00:00
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journal_title:European heart journal
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doi:10.1093/eurheartj/ehm243
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更新日期:1992-07-01 00:00:00
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journal_title:European heart journal
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更新日期:1999-10-01 00:00:00
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journal_title:European heart journal
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doi:10.1016/j.ehj.2004.01.010
更新日期:2004-04-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:1990-08-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/oxfordjournals.eurheartj.a060237
更新日期:1992-05-01 00:00:00
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journal_title:European heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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journal_title:European heart journal
pub_type: 杂志文章
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更新日期:2009-05-01 00:00:00
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journal_title:European heart journal
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doi:10.1093/eurheartj/ehv599
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/10.suppl_h.22
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pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a059849
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