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2019, vol. 147, br. 3-4, str. 167-172
Kliničke karakteristike i zbrinjavanje starijih bolesnika sa infarktom miokarda
aUniverzitet u Novom Sadu, Medicinski fakultet, Institut za kardiovaskularne bolesti + Univerzitet u Novom Sadu, Medicinski fakultet
bUniverzitet u Novom Sadu, Medicinski fakultet + Institut za plućne bolesti, Sremska Kamenica

e-adresaigor.ivanov@ikvbv.ns.ac.rs
Sažetak
Uvod/Cilj Populacija starijih ljudi je u porastu i moderna medicina se susreće sa problemom velikog morbiditeta i mortaliteta od kardiovaskularnih bolesti u ovoj starosnoj grupi. Moderne strategije lečenja još uvek nisu dovoljno ispitane kod starijih, pa su ovi ljudi često suboptimalno lečeni. Cilj istraživanja je da se ispitaju kliničke karakteristike, kardiološki faktori rizika, strategije zbrinjavanja i rani ishod kod starijih bolesnika sa infarktom miokarda sa ST elevacijom (STEMI). Metode Retrospektivna studija je uključila 217 uzastopnih bolesnika životne dobi ≥ 70 godina (srednje životne dobi 77,6 ± 4,9 godina, 103 muškaraca i 114 žena) sa STEMI, primljenih u Institut za kardiovaskularne bolesti Vojvodine. Analizirane su kliničke karakteristike, faktori rizika, funkcija leve komore i strategije lečenja u odnosu na bolnički ishod bolesti. Rezultati Prvi klinički simptom je bio bol u grudima, koji je bio zastupljen kod 96,3% bolesnika. Pri prijemu 35 (16,1%) bolesnika je imalo ozbiljne znake srčane slabosti (Kilipova klasa III-IV). Vreme od pojave tegoba do prijema u bolnicu je bilo 14,7 ± 28,6 sati. Od 217 bolesnika, 168 (77,4%) dobilo je reperfuzioni tretman, uključujući primarnu perkutanu koronarnu intervenciju (PPKI) kod 164 (75,6%) bolesnika i fibrinolizu kod četiri (1,8%) bolesnika. Hospitalni mortalitet je bio 26,3% (57 bolesnika). PPKI je bio univarijantni prediktor niskog intrahospitalnog mortaliteta, a multivarijantni prediktori hospitalnog mortaliteta su kardiogeni šok (OR 67,095; 95% CI (6,845-657,646); p < 0,001) i niska ejekciona frakcija leve komore (OR 0,901; 95% CI (0,853-0,963); p = 0,001). Zaključak Kod starijih bolesnika sa STEMI, PPKI je bila povezana sa manjim bolničkim mortalitetom, dok su kardiogeni šok i niska ejekciona frakcija leve komore bili nezavisni prediktori lošije prognoze posle STEMI.
Reference
*** (2017) Zdravstveno-statistički godišnjak Republike Srbije 2016. Beograd: Institut za javno zdravlje Srbije 'Dr Milan Jovanović Batut'
*** (2016) Incidencija i mortalitet od akutnog koronarnog sindroma u Srbiji. Registar za akutni koronarni sindrom u Srbiji. Izveštaj. Beograd: Institut za javno zdravlje Srbije 'Dr Milan Jovanović Batut', br. 11
Angeli, F., Verdecchia, P., Savonitto, S., Morici, N., de Servi, S., Cavallini, C. (2014) Early invasive versus selectively invasive strategy in patients with non-ST-segment elevation acute coronary syndrome: Impact of age. Catheterization and Cardiovascular Interventions, 83(5): 686-701
Batchelor, W.B., Anstrom, K.J., Muhlbaier, L.H., Grosswald, R., Weintraub, W.S., O’Neill, W.W., Peterson, E.D. (2000) Contemporary outcome trends in the elderly undergoing percutaneous coronary interventions: Results in 7,472 octogenarians. Journal of the American College of Cardiology, 36(3): 723-730
Bhatia, L.C., Naik, R.H. (2013) Clinical profile of acute myocardial infarction in elderly patients. Journal of Cardiovascular Disease Research, 4(2): 107-111
Bueno, H., Betriu, A., Heras, M., Alonso, J.J., Cequier, A., García, E.J., et al. (2011) Primary angioplasty vs fibrinoly sis in very old patients with acute myocardial infarction: TRIANA (TRatamiento del Infarto Agudo de miocardio eN Ancianos) random ized trial and pooled analysis with previous studies. Eur Heart J., 32(1): 51-60
Daneault, B., Généreux, P., Kirtane, A.J., Witzenbichler, B., Guagliumi, G., Paradis, J., Fahy, M.P., Mehran, R., Stone, G.W. (2013) Comparison of Three-Year Outcomes After Primary Percutaneous Coronary Intervention in Patients With Left Ventricular Ejection Fraction <40% Versus ≥40% (from the HORIZONS-AMI Trial). American Journal of Cardiology, 111(1): 12-20
DeGeare, V.S., Boura, J.A., Grines, L.L., O’Neill, W.W., Grines, C.L. (2001) Predictive value of the Killip classification in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction. American Journal of Cardiology, 87(9): 1035-1038
El-Menyar, A., Zubaid, M., AlMahmeed, W., Sulaiman, K., AlNabti, A., Singh, R., Suwaidi, J.A. (2012) Killip classification in patients with acute coronary syndrome: insight from a multicenter registry. American Journal of Emergency Medicine, 30(1): 97-103
Engberding, N., Wenger, N.K. (2017) Acute Coronary Syndromes in the Elderly. F1000Research, 6(): 1791
Galderisi, M., Cosyns, B., Edvardsen, T., Cardim, N., Delgado, V., di Salvo, G., Donal, E., Sade, L.E., Ernande, L., Garbi, M., Grapsa, J., Hagendorff, A., Kamp, O., Magne, J., Santoro, C. (2017) Standardization of adult transthoracic echocardiography reporting in agreement with recent chamber quantification, diastolic function, and heart valve disease recommendations: an expert consensus document of the European Association of Cardiovascular. European Heart Journal - Cardiovascular Imaging, 18(12): 1301-1310
Gharacholou, S. M., Lopes, R.D., Alexander, K.P., Mehta, R.H., Stebbins, A.L., Pieper, K.S., James, S.K., Armstrong, P.W., Granger, C.B. (2011) Age and Outcomes in ST-Segment Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention. Archives of Internal Medicine, 171(6):559-67
Goch, A., Misiewicz, P., Rysz, J., Banach, M. (2009) The Clinical Manifestation of Myocardial Infarction in Elderly Patients. Clinical Cardiology, 32(6): E45-E50
GUSTO investigators (1993) An International Randomized Trial Comparing Four Thrombolytic Strategies for Acute Myocardial Infarction. New England Journal of Medicine, 329(10): 673-682
Ibanez, B., James, S., Agewall, S., Antunes, M.J., Bucciarelli-Ducci, C., Bueno, H., et al. (2018) 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with STsegment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European S. Eur Heart J., 39: 119-77
Leal, M.F., Souza, F.N.F.S.de, Haggi, F.H., Klosoviski, E.R., Munhoz, E.C. (2002) Acute myocardial infarction in elderly patients: comparative analysis of the predictors of mortality. The elderly versus the young. Arquivos Brasileiros de Cardiologia, 79(4): 369-374
Leonardi, S., Bueno, H., Ahrens, I., Hassager, C., Bonnefoy, E., Lettino, M. (2018) Optimised care of elderly patients with acute coronary syndrome. European Heart Journal: Acute Cardiovascular Care, 7(3): 287-295
Montisci, R., Cacace, C., Congia, M., Marchetti, M.F., Roberta, S., Caddeo, P., Meloni, L. (2018) St elevation myocardial infarction in elderly and very elderly patients. Journal of the American College of Cardiology, 71(11): A200
Mukherjee, J.T., Beshansky, J.R., Ruthazer, R., Alkofide, H., Ray, M., Kent, D., Manning, W.J., Huggins, G.S., Selker;, H.P. (2015) In-hospital measurement of left ventricular ejection fraction and one-year outcomes in acute coronary syndromes: results from the IMMEDIATE Trial. Cardiovascular Ultrasound, 14(1): 2-8
Peiyuan, H., Jingang, Y., Haiyan, X., Xiaojin, G., Ying, X., Yuan, W., Wei, L., Yang, W., Xinran, T., Ruohua, Y., Chen, J., Lei, S., Xuan, Z., Rui, F., Yunqing, Y., Qiuting, D., Hui, S., Xinxin, Y., Runlin, G., Yuejin, Y. (2016) The Comparison of the Outcomes between Primary PCI, Fibrinolysis, and No Reperfusion in Patients ≥ 75 Years Old with ST-Segment Elevation Myocardial Infarction: Results from the Chinese Acute Myocardial Infarction (CAMI) Registry. PLoS One, 11(11): e0165672
Saunderson, C. E. D., Brogan, R. A., Simms, A. D., Sutton, G., Batin, P. D., Gale, C. P. (2014) Acute coronary syndrome management in older adults: guidelines, temporal changes and challenges. Age and Ageing, 43(4): 450-455
Schoenenberger, A.W., Radovanovic, D., Windecker, S., Iglesias, J.F., Pedrazzini, G., Stuck, A.E., Erne, P. (2016) Temporal trends in the treatment and outcomes of elderly patients with acute coronary syndrome. European Heart Journal, 37(16): 1304-1311
Solomon, C.G., Lee, T.H., Cook, E., Weisberg, M.C., Brand, D.A., Rouan, G.W., Goldman, L. (1989) Comparison of clinical presentation of acute myocardial infarction in patients older than 65 years of age to younger patients: The multicenter chest pain study experience. American Journal of Cardiology, 63(12): 772-776
Thygesen, K., Alpert, J.S., Jaffe, A.S., Simoons, M.L., Chaitman, B.R., White, H.D., et al. (2012) Third universal definition of myocardial infarction. Eur Heart J., 33(20): 2551-67
Toleva, O., Ibrahim, Q., Brass, N., Sookram, S., Welsh, R. (2015) Treatment choices in elderly patients with ST: elevation myocardial infarction—insights from the Vital Heart Response registry. Open Heart, 2(1): e000235
Tsai, J.P., Chen, Y.C., Hung, C.L., Cheng, H.Y., Jia-Yin,, Hou, C., et al. (2011) Reduced in-hospital mortality in patients with acute myocardial infarction after practice of percutaneous coronary intervention at a remote hospital in Taiwan. Acta Cardiol Sin., 27: 86-93
Viana-Tejedor, A., Loughlin, G., Fernández-Avilés, F., Bueno, H. (2015) Temporal trends in the use of reperfusion therapy and outcomes in elderly patients with first ST elevation myocardial infarction. European Heart Journal: Acute Cardiovascular Care, 4(5): 461-467
Widimsky, P., Motovská, Z., Bílková, D., Aschermann, M., Groch, L., Zelízko, M. (2007) The impact of age and Killip class on outcomes of primary percutaneous coronary intervention. Insight from the PRAGUE-1 and -2 trials and registry. EuroIntervention, 2(4): 481-6
Xuming, D.A.I., Whitehead, J.B., Karen, P.A. (2016) Acute coronary syndrome in the older adults. J Geriatr Cardiol, 13(2): 101-8
Zaman, M. J., Stirling, S., Shepstone, L., Ryding, A., Flather, M., Bachmann, M., Myint, P. K. (2014) The association between older age and receipt of care and outcomes in patients with acute coronary syndromes: a cohort study of the Myocardial Ischaemia National Audit Project (MINAP). European Heart Journal, 35(23): 1551-1558
 

O članku

jezik rada: engleski
vrsta rada: originalan članak
DOI: 10.2298/SARH171016011D
objavljen u SCIndeksu: 07.07.2019.