Multiple factors motivate no reperfusion in STEMI

August 2, 2012
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.

Explore further: Some 90-year-old heart attack patients have 'excellent' outcomes with coronary stenting

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

Related Stories

Some 90-year-old heart attack patients have 'excellent' outcomes with coronary stenting

March 25, 2012
Selected patients 90 years and older who experience an acute heart attack, or ST-elevation myocardial infarction (STEMI), have reasonable outcomes with coronary stenting, and should be considered for reperfusion therapy, ...

Most heart-attack patients needing procedure at another hospital not transferred in recommended time

June 21, 2011
Only about 10 percent of patients with a certain type of heart attack who need to be transferred to another hospital for a PCI (procedures such as balloon angioplasty or stent placement used to open narrowed coronary arteries) ...

Statewide coordinated STEMI approach deemed successful

June 5, 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 percutaneous ...

Time trends in STEMI -- improved treatment and outcome but gender gap persists

August 29, 2011
In spite of an increased attention to gender differences in treatment of myocardial infarctions, focus on adherence to guidelines and a change in predominant therapy, the gender difference in treatment and mortality regarding ...

Recommended for you

Starting periods before age of 12 linked to heightened risk of heart disease and stroke

January 15, 2018
Starting periods early—before the age of 12—is linked to a heightened risk of heart disease and stroke in later life, suggests an analysis of data from the UK Biobank study, published online in the journal Heart.

'Decorated' stem cells could offer targeted heart repair

January 10, 2018
Although cardiac stem cell therapy is a promising treatment for heart attack patients, directing the cells to the site of an injury - and getting them to stay there - remains challenging. In a new pilot study using an animal ...

Two simple tests could help to pinpoint cause of stroke

January 10, 2018
Detecting the cause of the deadliest form of stroke could be improved by a simple blood test added alongside a routine brain scan, research suggests.

Exercise is good for the heart, high blood pressure is bad—researchers find out why

January 10, 2018
When the heart is put under stress during exercise, it is considered healthy. Yet stress due to high blood pressure is bad for the heart. Why? And is this always the case? Researchers of the German Centre for Cardiovascular ...

Heart-muscle patches made with human cells improve heart attack recovery

January 10, 2018
Large, human cardiac-muscle patches created in the lab have been tested, for the first time, on large animals in a heart attack model. This clinically relevant approach showed that the patches significantly improved recovery ...

Place of residence linked to heart failure risk

January 9, 2018
Location. Location. Location.

0 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.