...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>The American Journal of Cardiology >Influence of age on use of cardiac catheterization and associated outcomes in patients with non-ST-elevation acute coronary syndromes.
【24h】

Influence of age on use of cardiac catheterization and associated outcomes in patients with non-ST-elevation acute coronary syndromes.

机译：年龄对非ST段抬高的急性冠状动脉综合征患者心脏导管使用及相关结局的影响。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Randomized controlled trials support the use of an early invasive strategy in high-risk patients with non-ST-segment elevation (NSTE) acute coronary syndromes (ACS). Although risk increases with age, limited data are available to support this strategy in older patients. The aims of this study were to examine temporal trends in the management and outcomes of NSTE ACS in elderly patients and to explore reasons for the lower use of early angiography in the aged population. Data from 11,732 patients with NSTE ACS were collected from 3 consecutive Canadian registries (ACS I, ACS II, and Global Registry of Acute Coronary Events [GRACE]/GRACE2) from 1999 to 2007. Rates of in-hospital cardiac catheterization, revascularization, infarction or reinfarction, and death were stratified by age (<65, 65 to 74, and > or = 75 years). Although overall, rates of in-hospital catheterization and revascularization increased over time (p <0.001), the largest increase occurred in patients aged <65 years. The strongest independent negative predictor of the use of cardiac catheterization was age > or = 75 years (adjusted odds ratio 0.45, 95% confidence interval 0.37 to 0.56, p <0.001). Use of an early invasive approach was associated with a reduction in 1-year mortality across all age groups, but the absolute difference was greatest in patients aged > or = 75 years. The underestimation of risk by physicians (ascertained in ACS II) was the most common reason for choosing a conservative strategy. In conclusion, despite an overall increased use of an early invasive strategy, elderly patients with NSTE ACS remain significantly less likely to undergo cardiac catheterization and revascularization and are often erroneously perceived to be at low risk by their physicians. Future studies should determine whether more aggressive treatment of these high-risk elderly patients improves outcomes.
机译：随机对照试验支持在非ST段抬高（NSTE）急性冠状动脉综合征（ACS）的高危患者中使用早期侵入性策略。尽管风险会随着年龄的增长而增加，但是对于老年患者，只有有限的数据支持该策略。这项研究的目的是检查老年患者NSTE ACS的管理和转归的时间趋势，并探讨老年人中早期血管造影术使用率较低的原因。从1999年至2007年连续三个加拿大注册机构（ACS I，ACS II和全球急性冠脉事件[GRACE] / GRACE2）收集了11,732例NSTE ACS患者的数据。院内心脏导管插入，血运重建，梗死的发生率或再梗塞，并按年龄（<65岁，65至74岁，以及>或= 75岁）对死亡进行分层。尽管总的来说，院内导管插入和血运重建率随时间增加（p <0.001），最大的增加发生在<65岁的患者中。使用心脏导管检查的最强的独立阴性预测因素是年龄>或= 75岁（校正比值比0.45，95％置信区间0.37至0.56，p <0.001）。在所有年龄组中，使用早期侵入性治疗方法均可以降低1年死亡率，但对于年龄≥75岁的患者，绝对差异最大。医生对风险的低估（在ACS II中确定）是选择保守策略的最常见原因。总之，尽管整体上增加了早期侵入性策略的使用，但患有NSTE ACS的老年患者仍然明显较少接受心脏导管插入术和血运重建术，并且通常被其医生误认为其处于低风险中。未来的研究应确定对这些高危老年患者进行更积极的治疗是否可以改善预后。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号