Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/13774
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dc.contributor.authorYudi, Matias B-
dc.contributor.authorJones, N-
dc.contributor.authorFernando, Dharsh-
dc.contributor.authorClark, David J-
dc.contributor.authorRamchand, Jay-
dc.contributor.authorJones, Elizabeth F-
dc.contributor.authorDakis, R-
dc.contributor.authorJohnson, Douglas F-
dc.contributor.authorChan, Robert K-
dc.contributor.authorIslam, Amirul-
dc.contributor.authorFarouque, Omar-
dc.contributor.authorHorrigan, Mark-
dc.date2016-04-22-
dc.date.accessioned2016-05-11T01:42:10Z-
dc.date.accessioned2016-05-11T01:44:24Z-
dc.date.accessioned2016-05-11T01:44:23Z-
dc.date.available2016-05-11T01:42:10Z-
dc.date.available2016-05-11T01:44:23Z-
dc.date.available2016-05-11T01:44:24Z-
dc.date.issued2016-07-01-
dc.identifier.citationThe American Journal of Cardiology 2016; 118(1): 44-48en
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/13774-
dc.description.abstractGuidelines mandate urgent revascularization in patients presenting with ST-elevation myocardial infarction (STEMI) irrespective of age. Whether this strategy is optimal in patients aged ≥85 years remains uncertain. We aimed to assess the clinical characteristics and outcomes of patients aged ≥85 years with STEMI stratified by their management strategy. We analyzed baseline clinical characteristics of 101 consecutive patients aged ≥85 years that presented with STEMI to a tertiary Australian hospital. Patients were stratified based on whether they underwent invasive management with urgent coronary angiography ± percutaneous coronary intervention or conservative management. Our primary outcome was long-term mortality. Independent predictors of conservative management and long-term mortality were assessed by multivariate logistic regression and Cox proportional hazard modeling respectively. Of the 101 patients included, 45 underwent invasive management. Independent predictors of having conservative management were older age, anterior STEMI and cognitive impairments (all p<0.01). Patients managed invasively had lower in-hospital (13.3% vs. 32.1%, p=0.03), 30-day (13.3% vs. 37.5%, p<0.01), 12-month (22.2% vs. 57.1%, p<0.01) and long-term (40.0% vs. 75.0%, p<0.01) mortality. Invasive management was an independent predictor of lower long-term mortality (hazard ratio 0.29, 95% confidence interval 0.11 – 0.76, p<0.01). In conclusion, patients aged ≥85 years with STEMI who were older, had cognitive impairment or presented with anterior ST-elevation were more likely to be managed conservatively. Those who underwent invasive management had reasonable short and long-term outcomes.en
dc.subjectMyocardial Infarctionen
dc.subjectMortalityen
dc.titleManagement of patients ≥85 years of age with ST-elevation myocardial infarctionen
dc.typeJournal Articleen
dc.identifier.journaltitleThe American Journal of Cardiologyen
dc.identifier.affiliationDepartment of Cardiology, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationDepartment of Medicine, Western Healthen
dc.identifier.affiliationDepartment of Medicine, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationDepartment of Statistics, Data Science and Epidemiology, Faculty of Health, Arts and Design, Swinburne University of Technologyen
dc.identifier.doi10.1016/j.amjcard.2016.04.010en
dc.type.contentTexten
dc.identifier.orcid0000-0002-3706-4150en
dc.type.austinJournal Articleen_US
local.name.researcherChan, Robert K
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.openairetypeJournal Article-
crisitem.author.deptCardiology-
crisitem.author.deptCardiology-
crisitem.author.deptCardiology-
crisitem.author.deptUniversity of Melbourne Clinical School-
crisitem.author.deptCardiology-
crisitem.author.deptMedicine (University of Melbourne)-
crisitem.author.deptCardiology-
crisitem.author.deptCardiology-
crisitem.author.deptCardiology-
crisitem.author.deptCardiology-
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