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

Low-salt and heart-healthy dash diet as effective as drugs for some adults with high blood pressure

November 22, 2017
A study of more than 400 adults with prehypertension, or stage 1 high blood pressure, found that combining a low-salt diet with the heart-healthy DASH diet substantially lowers systolic blood pressure—the top number in ...

Stroke patients may have more time to get treatment, study finds

November 22, 2017
Patients and doctors long have relied on a simple rule of thumb for seeking care after an ischemic stroke: "Time is brain."

Cases of heart failure continue to rise; poorest people worst affected

November 22, 2017
The number of people being diagnosed with heart failure in the UK continues to rise as a result of demographic changes common to many developed countries, new research by The George Institute for Global Health at the University ...

Some cancer therapies may provide a new way to treat high blood pressure

November 20, 2017
Drugs designed to halt cancer growth may offer a new way to control high blood pressure (hypertension), say Georgetown University Medical Center investigators. The finding could offer a real advance in hypertension treatment ...

Could this protein protect people against coronary artery disease?

November 17, 2017
The buildup of plaque in the heart's arteries is an unfortunate part of aging. But by studying the genetic makeup of people who maintain clear arteries into old age, researchers led by UNC's Jonathan Schisler, PhD, have identified ...

Raising 'good' cholesterol fails to protect against heart disease

November 16, 2017
Raising so-called 'good' cholesterol by blocking a key protein involved in its metabolism does not protect against heart disease or stroke, according to a large genetic study of 150,000 Chinese adults published in the journal ...

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.