Multiple factors motivate no reperfusion in STEMI

Multiple factors motivate no reperfusion in STEMI
For patients presenting with ST-segment elevation myocardial infarction, the decision for no reperfusion is usually multifactorial, with the most common factor being advanced age, according to a study published in the Aug. 15 issue of The American Journal of Cardiology.

(HealthDay) -- For patients presenting with ST-segment elevation myocardial infarction (STEMI), the decision for no reperfusion is usually multifactorial, with the most common factor being advanced age, according to a study published in the Aug. 15 issue of The American Journal of Cardiology.

To examine the reasons underlying the decision not to give in patients with STEMI and the outcomes for these patients, Frances O. Wood, M.D., from William Beaumont Hospital in Royal Oak, Mich., and colleagues identified 139 patients (mean age, 80 years; 61 percent women, 31 percent with diabetes, and 37 percent with known ) from a total of 1,126 patients with STEMI who did not undergo reperfusion therapy at a high-volume percutaneous coronary intervention center, from October 2006 to March 2011.

The researchers found that 52 percent of the 139 patients presented with primary diagnoses other than STEMI, and 28 percent developed STEMI more than 24 hours after admission. Advanced age, comorbid conditions, acute or chronic kidney injury, delayed presentation, advance directives precluding reperfusion, patient preference, and dementia were the most common reasons for no reperfusion. Sixty percent of the patients had three or more reasons for no reperfusion. Cardiogenic shock, intubation, and advance directives prohibiting reperfusion after physician consultation were associated with hospital mortality. In-hospital mortality was 53 percent and one-year mortality was 69 percent.

"The decision for no reperfusion was multifactorial, with advanced age reported as the most common factor," the authors write. "Outcomes were poor in this population, and fewer than half of these patients survived to hospital discharge."

One author disclosed to pharmaceutical and medical device companies.

More information: Abstract
Full Text (subscription or payment may be required)

add to favorites email to friend print save as pdf

Related Stories

Statewide coordinated STEMI approach deemed successful

Jun 05, 2012

(HealthDay) -- A statewide coordinated effort across hospitals and emergency medical service (EMS) providers to transport patients with ST-segment elevation myocardial infarction (STEMI) to hospitals providing ...

Recommended for you

Most seniors eligible for statin Rx under new guidelines

7 hours ago

(HealthDay)—Most older Americans qualify for treatment with statins under new guidelines for the treatment of blood cholesterol released late last year by the American College of Cardiology and the American ...

Asymptomatic atherosclerosis linked to cognitive impairment

22 hours ago

In a study of nearly 2,000 adults, researchers found that a buildup of plaque in the body's major arteries was associated with mild cognitive impairment. Results of the study conducted at the University of Texas (UT) Southwestern ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.