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

Gene therapy improved left ventricular and atrial function in heart failure by up to 25 percent

September 25, 2017
Heart function improved by up to 25 percent in a trial using gene therapy to reverse cardiac damage from congestive heart failure in a large animal model, Mount Sinai researchers report. This is the first study using a novel ...

Tension makes the heart grow stronger

September 25, 2017
By taking videos of a tiny beating zebrafish heart as it reconstructs its covering in a petri dish, scientists have captured unexpected dynamics of cells involved in tissue regeneration. They found that the depleted heart ...

Hospital mortality rates after heart attack differ by age

September 25, 2017
Outcomes for older patients hospitalized for a heart attack are often used as a measure of hospital quality for all patients. But a study led by Yale researchers shows that hospital mortality rates for older patients with ...

Laser device placed on the heart identifies insufficient oxygenation better than other measures

September 20, 2017
A new device can assess in real time whether the body's tissues are receiving enough oxygen and, placed on the heart, can predict cardiac arrest in critically ill heart patients, report researchers at Boston Children's Hospital ...

Metabolism switch signals end for healing hearts

September 19, 2017
Researchers have identified the process that shuts down the human heart's ability to heal itself, and are now searching for a drug to reverse it.

Beta blockers not needed after heart attack if other medications taken

September 18, 2017
A new study from the University of North Carolina at Chapel Hill finds beta blockers are not needed after a heart attack if heart-attack survivors are taking ACE inhibitors and statins. The study is the first to challenge ...

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.