Netherlands Heart Journal ( IF 2 ) Pub Date : 2023-09-28 , DOI: 10.1007/s12471-023-01812-0 Marieke E Gimbel 1 , Dean R P P Chan Pin Yin 1 , Wout W A van den Broek 1 , Renicus S Hermanides 2 , Floris Kauer 3 , Annerieke H Tavenier 2 , Dirk Schellings 4 , Stijn L Brinckman 5 , Salem H K The 6 , Martin G Stoel 7 , Ton A C M Heestermans 8 , Saman Rasoul 9, 10 , Mireille E Emans 11 , Machiel van de Wetering 12 , Paul F M M van Bergen 13 , Ronald Walhout 14 , Debby Nicastia 15 , Ismail Aksoy 16 , Arnoud van 't Hof 9, 10 , Paul Knaapen 17 , Cees-Joost Botman 18 , Anho Liem 19 , Cornelis de Nooijer 20 , Joyce Peper 1 , Johannes C Kelder 1 , Jurriën M Ten Berg 1
|
Objective
We describe the current treatment of elderly patients with non-ST-elevation myocardial infarction (NSTEMI) enrolled in a national registry.
Methods
The POPular AGE registry is a prospective, multicentre study of patients ≥ 75 years of age presenting with NSTEMI, performed in the Netherlands. Management was at the discretion of the treating physician. Cardiovascular events consisted of cardiovascular death, myocardial infarction and ischaemic stroke. Bleeding was classified according to the Bleeding Academic Research Consortium (BARC) criteria.
Results
A total of 646 patients were enrolled between August 2016 and May 2018. Median age was 81 (IQR 77–84) years and 58% were male. Overall, 75% underwent coronary angiography, 40% percutaneous coronary intervention, and 11% coronary artery bypass grafting, while 49.8% received pharmacological therapy only. At discharge, dual antiplatelet therapy (aspirin and P2Y12 inhibitor) was prescribed to 56.7%, and 27.4% received oral anticoagulation plus at least one antiplatelet agent. At 1‑year follow-up, cardiovascular death, myocardial infarction or stroke had occurred in 13.6% and major bleeding (BARC 3 and 5) in 3.9% of patients. The risk of both cardiovascular events and major bleeding was highest during the 1st month. However, cardiovascular risk was three times as high as bleeding risk in this elderly population, both after 1 month and after 1 year.
Conclusions
In this national registry of elderly patients with NSTEMI, the majority are treated according to current European Society of Cardiology guidelines. Both the cardiovascular and bleeding risk are highest during the 1st month after NSTEMI. However, the cardiovascular risk was three times as high as the bleeding risk.
中文翻译：
老年非 ST 段抬高型心肌梗死患者的治疗：全国 POPular 年龄登记处
客观的
我们描述了国家登记处登记的非 ST 段抬高型心肌梗死 (NSTEMI) 老年患者的当前治疗方法。
方法
POPular AGE 登记是一项前瞻性、多中心研究，对象是 75 岁以上患有 NSTEMI 的患者，在荷兰进行。治疗由主治医生决定。心血管事件包括心血管死亡、心肌梗塞和缺血性中风。出血根据出血学术研究联盟 (BARC) 标准进行分类。
结果
2016 年 8 月至 2018 年 5 月期间，共有 646 名患者入组。中位年龄为 81（IQR 77-84）岁，其中 58% 为男性。总体而言，75% 的人接受了冠状动脉造影，40% 的人接受了经皮冠状动脉介入治疗，11% 的人接受了冠状动脉旁路移植术，而 49.8% 的人仅接受了药物治疗。出院时，56.7% 的患者接受双重抗血小板治疗（阿司匹林和 P2Y 12抑制剂），27.4% 的患者接受口服抗凝药物加至少一种抗血小板药物。1 年随访时，13.6% 的患者发生心血管死亡、心肌梗塞或中风，3.9% 的患者发生大出血（BARC 3 和 5）。心血管事件和大出血的风险在第一个月最高。然而，在老年人群中，1个月后和1年后，心血管风险是出血风险的三倍。
结论
在国家老年 NSTEMI 患者登记中，大多数患者按照欧洲心脏病学会现行指南进行治疗。NSTEMI 后第一个月内心血管和出血风险最高。然而，心血管风险是出血风险的三倍。
京公网安备 11010802027423号