Abstract:
AIMS:To test the hypothesis that increasing age in patients presenting with high-risk non-ST-segment elevation acute coronary syndromes (NSTE-ACS) does not adversely influence the benefit of an early invasive strategy on major adverse events at 6 months. METHODS AND RESULTS:We report clinical outcomes in young (<70), elderly (70-80), and very elderly (>80 years) patients with high-risk NSTE-ACS enrolled in GRACE between 1999 and 2006. Six month data were available in 18 466 patients (27% elderly, 16% very elderly). Elderly and very elderly patients were less likely to receive evidence-based treatments at discharge and had a longer hospital stay (6 vs. 5 days). Angiography was performed more frequently in younger patients (67 vs. 33% in very elderly, 55% in elderly; P < 0.0001). Multiple logistic regression analysis confirmed the benefit of revascularization on the primary study endpoint (6-month stroke, death, myocardial infarction) in young [odds ratio (OR) 0.69, 95% confidence interval (CI) 0.56-0.86], elderly (0.60, 0.47-0.76), and very elderly (0.72, 0.54-0.95) patients. Revascularization was associated with reductions in 6-month mortality (OR 0.52, 95% CI 0.37-0.72 in young; 0.38, 0.26-0.54 in elderly; 0.68, 0.49-0.95 in very elderly). Stroke risk in hospital or at 6 months was not increased by revascularization. CONCLUSION:Following presentation with high-risk NSTE-ACS, an evidence-based approach to management was noted less frequently with advancing patient age. Angiography, in particular, was less likely to be undertaken. Revascularization, however, when performed, was associated with significant benefits at 6 months, independent of age, and did not increase risk of stroke.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Devlin G,Gore JM,Elliott J,Wijesinghe N,Eagle KA,Avezum A,Huang W,Brieger D,GRACE Investigators.doi
10.1093/eurheartj/ehn124subject
Has Abstractpub_date
2008-05-01 00:00:00pages
1275-82issue
10eissn
0195-668Xissn
1522-9645pii
ehn124journal_volume
29pub_type
杂志文章abstract::The aim of this study was to investigate the haemodynamic effects of amrinone in patients with pulmonary hypertension and impaired right ventricular function. Twelve patients with mitral stenosis (NYHA classification III and IV) took part in the study. The haemodynamic measurements were performed in the steady state u...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a062142
更新日期:1986-09-01 00:00:00
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doi:10.1093/eurheartj/14.suppl_g.2
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journal_title:European heart journal
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doi:10.1053/euhj.1998.1092
更新日期:1998-10-01 00:00:00
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journal_title:European heart journal
pub_type: 临床试验,杂志文章
doi:10.1093/eurheartj/8.7.754
更新日期:1987-07-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章,评审
doi:
更新日期:1993-11-01 00:00:00
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pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060895
更新日期:1995-02-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060920
更新日期:1995-03-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/5.suppl_c.77
更新日期:1984-10-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章,评审
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更新日期:2018-08-14 00:00:00
abstract:: ...
journal_title:European heart journal
pub_type: 评论,杂志文章
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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
doi:10.1093/oxfordjournals.eurheartj.a015226
更新日期:1997-02-01 00:00:00
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journal_title:European heart journal
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doi:10.1093/eurheartj/ehi009
更新日期:2005-02-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1093/eurheartj/ehi877
更新日期:2006-05-01 00:00:00
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pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a015449
更新日期:1997-08-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a062518
更新日期:1988-04-01 00:00:00
abstract::Promising approaches towards new therapeutic strategies in coronary heart disease might emerge from an improved pathophysiological understanding of the role of certain peptides, which require a localizing event for their accumulation or expression in the coronary vasculature. Temporal myocardial ischaemia or hypoperfu...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/12.suppl_f.112
更新日期:1991-12-01 00:00:00
abstract:AIM:A genetic variant (rs20417) of the PTGS2 gene, encoding for COX-2, has been associated with decreased COX-2 activity and a decreased risk of cardiovascular disease (CVD). However, this genetic association and the role of COX-2 in CVD remain controversial. METHODS AND RESULTS:The association of rs20417 with CVD was...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehu168
更新日期:2014-09-01 00:00:00
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pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehq308
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pub_type: 杂志文章
doi:10.1093/eurheartj/ehz727
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pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a014878
更新日期:1996-03-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.1999.1714
更新日期:1999-12-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/10.suppl_g.54
更新日期:1989-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1093/eurheartj/5.suppl_f.225
更新日期:1984-12-01 00:00:00
abstract::The steady state plasma concentrations of the two platelet-specific proteins beta-thromboglobulin (BTG) and platelet factor 4 (PF4) were determined in two groups of females: 36 acute myocardial infarction (AMI) survivors, and 38 age-matched control subjects. For the AMI patients the mean BTG and PF4 values were 57 +/-...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061465
更新日期:1983-05-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/16.suppl_a.42
更新日期:1995-03-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehv008
更新日期:2015-05-14 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.a015069
更新日期:1996-09-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1093/eurheartj/ehq468
更新日期:2011-03-01 00:00:00
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pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060150
更新日期:1992-02-01 00:00:00