Unit:
Κατεύθυνση Επεμβατική ΚαρδιολογίαLibrary of the School of Health Sciences
Author:
Papakonstantinou Nikolaos
Supervisors info:
Τσιάμης Ελευθέριος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Κυρίτση Ελένη, Ομότιμη Καθηγήτρια, Τμήμα Νοσηλευτικής, ΤΕΙ Αθήνας
Τούσουλης Δημήτριος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Αιμορραγικές επιπλοκές σε ασθενείς με STEMI ηλικίας ≥80 ετών που υποβάλλονται σε πρωτογενή αγγειοπλαστική
Translated title:
Bleeding complications in patients ≥80 years old with STEMI undergoing percutaneous primary coronary intervention
Summary:
Introduction: Percutaneous primary coronary intervention (pPCI) is the treatment of choice for patients with STEMI. However, due to the fragility of age, the coexistence of adverse comorbidities and the exclusion of this population from studies, it is doubtful whether the application of guidelines regarding ischemic and hemorrhagic endpoints has a positive effect on elderly people undergoing percutaneous primary coronary intervention.
The aim of this study is to investigate the incidence of bleeding complications in patients with STEMI aged ≥80 years undergoing percutaneous primary coronary intervention.
Material and Method: The study sample consisted of 103 patients with STEMI aged ≥ 80 years who underwent percutaneous primary coronary intervention during the years 2016-2019 and were hospitalized at the General Hospital of Athens "Hippocration" and the General Hospital of Piraeus . "Tzaneio". The study data were collected from the patients' medical records and their laboratory tests.
Results: The mean age of the patients was 84 years and 70% were men. 80% of patients had hypertension and 40% had diabetes, dyslipidemia and were smokers. As for the comorbidities of the sample, 20% suffered from chronic renal failure and had known anemia. Of the total patients, 40% were hospitalized due to anterior STEMI, with the same rate for inferior STEMI and 20% for STEMI of another location (lateral, posterior). In 40% of patients, percutaneous primary coronary intervention was performed via the femoral artery. 81.6% received dual antiplatelet therapy with aspirin and clopidogrel. Hemorrhagic complications occurred in 13.5%, most of whom were mild and associated with the puncture site (BARC 1) with a rate of 5.8%, while significant hemorrhagic complications (BARC 3) occurred in 5 patients with a rate of 4.9%. Patients who underwent pPCI via the femoral artery (p = 0.015), who used antiplatelet therapy (p = 0.005), with a known history of coronary artery disease (p = 0.047) and a low left ventricular ejection fraction (p = 0.031), had more frequent bleeding.
Conclusions: Bleeding complications are more common in elderly patients with STEMI who undergo percutaneous primary coronary intervention and are associated with comorbidities, the specific characteristics of this population as well as the pharmacological factors used during the operation.
Main subject category:
Health Sciences
Keywords:
Bleeding, Complications, STEMI, Elderly, Percutaneous primary coronary intervention
Number of references:
243
