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Temporal Trends in Mechanical Complications of Acute Myocardial Infarction in the Elderly

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dc.contributor.author Puerto, Elena
dc.contributor.author Viana-Tejedor, Ana
dc.contributor.author Martínez Sellés Oliveria Soares, Manuel
dc.contributor.author Domínguez-Pérez, Laura
dc.contributor.author Moreno, Guillermo
dc.contributor.author Martín Asenjo, Roberto
dc.contributor.author Bueno, Héctor
dc.date.accessioned 2018-11-21T19:24:20Z
dc.date.available 2018-11-21T19:24:20Z
dc.date.issued 2018
dc.identifier.citation Puerto, E., Viana-Tejedor, A., Martínez-Sellés, M., Domínguez-Pérez, L., Moreno, G., Martín-Asenjo, R., & Bueno, H. (2018). Temporal Trends in Mechanical Complications of Acute Myocardial Infarction in the Elderly. Journal of the American College of Cardiology, 72(9), 959-966. https://doi.org/10.1016/j.jacc.2018.06.031 spa
dc.identifier.issn 0735-1097
dc.identifier.issn 1558-3597
dc.identifier.uri http://hdl.handle.net/11268/7590
dc.description.abstract Background: Reperfusion therapy led to an important decline in mortality after ST-segment elevation myocardial infarction (STEMI). Because the rate of cardiogenic shock has not changed dramatically, the authors speculated that a reduction in the incidence or fatality rate of mechanical complications (MCs), the second cause of death in these patients, could explain this decrease. Objectives: This study sought to assess time trends in the incidence, management, and fatality rates of MC, and its influence on short-term mortality in old patients with STEMI. Methods: Trends in the incidence and outcomes of MC between 1988 and 2008 were analyzed by Mantel-Haenszel linear association test in 1,393 consecutive patients ≥75 years of age with first STEMI. Results: Overall in-hospital mortality decreased from 34.3% to 13.4% (relative risk reduction, 61%; p < 0.001). Although the absolute mortality due to MC decreased from 9.6% to 3.3% (p < 0.001), the proportion of deaths due to MC among all deaths did not change (28.1% to 24.5%; p = 0.53). The incidence of MC decreased from 11.1% to 4.3% (relative risk reduction 61%) with no change in their hospital fatality rate over time (from 87.1% to 82.4%; p = 0.66). The proportion of patients undergoing surgical repair decreased from 45.2% to 17.6% (p = 0.04), with no differences in post-operative survival (from 28.6% to 33.3%; p = 0.74). Conclusions: Although the incidence of MC has decreased substantially since the initiation of reperfusion therapy in elderly STEMI patients, this reduction was proportional to other causes of death and was not accompanied by an improvement in fatality rates, with or without surgery. MCs are less frequent but remain catastrophic complications of STEMI in these patients. spa
dc.description.sponsorship SIN FINANCIACIÓN spa
dc.language.iso eng spa
dc.title Temporal Trends in Mechanical Complications of Acute Myocardial Infarction in the Elderly spa
dc.type article spa
dc.description.impact 16.834 JCR (2017) Q1, 3/128 Cardiac & Cardiovascular Systems spa
dc.identifier.doi 10.1016/j.jacc.2018.06.031
dc.rights.accessRights closedAccess spa
dc.subject.uem Infarto de miocardio spa
dc.subject.uem Ancianos spa
dc.subject.unesco Enfermedad cardiovascular spa
dc.subject.unesco Anciano spa
dc.description.filiation UEM spa
dc.peerreviewed Si spa


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