Abstract
The increasing elderly population will influence the treatment policies adopted in cases of acute myocardial infarction. Considering reperfusion therapy in elderly patients with acute myocardial infarction, we compared three strategies, as follows: primary percutaneous coronary intervention (primary PCI: n = 26), facilitated PCI with half the standard dose of mutant tissue-type plasminogen activator (t-PA) (half + PCI: n = 24), and facilitated PCI with a standard dose of mutant t-PA (standard + PCI: n = 15) between patients 75 and 80 years of age. The rate of acquisition of thrombolysis in myocardial infarction (TIMI-3) flow on initial coronary arteriography was significantly lower in the primary PCI group than in the other two groups (7.7% in the primary PCI group vs 60% in the half + PCI and 66.7% in the standard + PCI group). The incidence of hemorrhagic complications including blood transfusion was not significantly different between primary PCI and facilitated PCI. Considering reperfusion therapy in elderly patients with acute myocardial infarction, we concluded that facilitated PCI may be effective in elderly patients aged 75–80 years.
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W Devlin D Cragg M Jacks H Friedman W O'Neill C Grines (1995) ArticleTitleComparison of outcome in patients with acute myocardial infarction aged >75 years with that in younger patients Am J Cardiol 75 573–576 Occurrence Handle7887380 Occurrence Handle1:STN:280:ByqC1MznsFU%3D Occurrence Handle10.1016/S0002-9149(99)80619-5
InstitutionalAuthorNameInternational Consensus On Science (2000) ArticleTitleGuideline 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Circulation 102 I172–I203
TJ Ryan EM Antman NH Brooks RM Califf LD Hillis LF Hiratzka E Rapaport B Riegel RO Russell EE Smith Suffix3rd WD Weaver RJ Gibbons JS Alpert KA Eagle TJ Gardner A Garson SuffixJr G Gregoratos SC Smith SuffixJr (1999) ArticleTitle1999 update: ACC/AHA guidelines for the management of patients with acute myocardial infarction: executive summary and recommendations: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction) Circulation 31 1016–1030
InstitutionalAuthorNameThe American Heart Association in collaboration with the International Liaison Committee on Resuscitation (ILCOR) (2000) ArticleTitleGuidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care: an international consensus on science Circulation 102 I1–I384
TJ Ryan JL Anderson EM Antman BA Braniff NH Brooks RM Califf LD Hillis LF Hiratzka E Rapaport BJ Riegel RO Russell EE Smith SuffixJr WD Weaver (1996) ArticleTitleACC/AHA guidelines for management of patients with acute myocardial infarction: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction) J Am Coll Cardiol 28 1328–1348 Occurrence Handle8890834 Occurrence Handle1:STN:280:ByiD2crptFY%3D Occurrence Handle10.1016/S0735-1097(96)00392-0
AM Ross KS Coyne JS Reiner SW Greenhouse C Fink A Frey E Moreyra M Traboulsi N Racine AL Riba MA Thompson S Rohrbeck CF Lundergan (1999) ArticleTitleA randomized trial comparing primary angioplasty with a strategy of short-acting thrombolysis and immediate planned rescue angioplasty in acute myocardial infarction: The PACT trial J Am Coll Cardiol 34 1954–1962 Occurrence Handle10588209 Occurrence Handle1:STN:280:DC%2BD3c%2FltlCgsg%3D%3D Occurrence Handle10.1016/S0735-1097(99)00444-1
DA Morrow EM Antman A Sayah KC Schuhwerk RP Giugliano JA deLemos M Waller SA Cohen DG Rosenberg SS Cutler CH McCabe RM Walls E Braunwald (2002) ArticleTitleEvaluation of the saved by prehospital initiation of reteplase for ST-elevation myocardial infarction. Result of the early retavase-thrombolysis in myocardial infarction (ER-TIMI) 19 Trial J Am Coll Cardiol 40 71–77 Occurrence Handle12103258 Occurrence Handle10.1016/S0735-1097(02)01936-8
E Bonnefoy F Lapostolle A Leizorovicz G Steg EP McFadden PY Dubien S Cattan E Boullenger J Machecourt JM Lacroute J Cassagnes F Dissait P Touboul (2002) ArticleTitleComparison of angioplasty and prehospital thromboysis in acute myocardial infarction study group. Primary angioplasty versus prehospital fibrinolysis in acute myocardial infarction: a randomized study Lancet 360 825–829 Occurrence Handle12243916 Occurrence Handle10.1016/S0140-6736(02)09963-4
M Dalby A Bouzamondo P Lechat G Montalescot (2003) ArticleTitleTransfer for primary angioplasty versus immediate thrombolysis in acute myocardial infarction. A meta-analysis Circulation 108 1809–1814 Occurrence Handle14530206 Occurrence Handle1:STN:280:DC%2BD3svnvV2qsg%3D%3D Occurrence Handle10.1161/01.CIR.0000091088.63921.8C
K Nagao N Hayashi K Kanmatsuse S Kikuchi T Ohuba H Takahashi (2002) ArticleTitleAn early and complete reperfusion strategy for acute myocardial infarction using fibrinolysis and subsequent transluminal thrapy. The FAST Trial Circ J 66 576–582 Occurrence Handle12074277 Occurrence Handle10.1253/circj.66.576
K Nagao K Kanmatsuse S Kikuchi K Satou I Watanabe K Arima (2001) ArticleTitleCombination reperfusion strategy of fibrinolysis and subsequent transluminal therapy for acute myocardial infarction: the FAST trial (abstract) Jpn Circ J 65 IssueIDSuppl 18
LM Brass JH Lichman Y Wang JH Gurwitz MJ Radford HM Krumholz (2000) ArticleTitleIntracranial hemorrhage associated with thrombolytic therapy for elderly patients with acute myocardial infarction. Results from the cooperative cardiovascular project Stroke 31 1802–1811 Occurrence Handle10926938 Occurrence Handle1:CAS:528:DC%2BD3cXlvFynsrk%3D
AJ Tiefenbrunn C Nisha NC Chandra WJ French M Joel JM Gore WJ Rogers (1998) ArticleTitleClinical experience with primary percutaneous transluminal coronary angioplasty compared with alteplase (recombinant tissue-type plasminogen activator) in patients with acute myocardial infarction: a report from the Second National Registry of Myocardial Infarction (NRMI-2) J Am Coll Cardiol 31 1240–1245 Occurrence Handle9581714 Occurrence Handle1:STN:280:DyaK1c3ktVyntA%3D%3D Occurrence Handle10.1016/S0735-1097(98)00094-1
W Gregg GW Stone L Cindy GL Grines KF Browne J Marco D Rothbaum J James O'Keefe GO Hartzler P Overlie B Donohue N Chelliah GC Timmis R Vlietstra M Strzelecki SO Puchrowicz WW O'Neill (1995) ArticleTitlePredictors of in-hospital and 6-month outcome after acute myocardial infarction in the reperfusion era: the primary angioplasty in myocardial infarction (PAMI) trial J Am Coll Cardiol 25 370–377 Occurrence Handle10.1016/0735-1097(94)00367-Y
K Watanabe K Nagao I Watanabe K Kanmatsuse (2004) ArticleTitleRelationship between the door-to-TIMI-3 flow time and the infarct size in patients suffering from acute myocardial infarction Circ J 68 280–285 Occurrence Handle15056821 Occurrence Handle10.1253/circj.68.280
K Kimura K Tsukahara T Usui J Okuda Y Kitamura M Kosuge T Sano S Tohyama O Yamanaka Y Yoshii S Umemura (2001) ArticleTitleLow-dose tissue plasminogen activator followed by planned rescue angioplasty reduces time to reperfusion for acute myocardial infarction treated at community hospitals Jpn Circ J 65 901–906 Occurrence Handle11665796 Occurrence Handle1:CAS:528:DC%2BD3MXns1Kjsr4%3D Occurrence Handle10.1253/jcj.65.901
HD White GI Barbash RM Califf RJ Simes CB Granger WD Weaver NS Kleiman PE Aylward JM Gore A Vahanian KL Lee AM Ross EJ Topol (1996) ArticleTitleAge and outcome with contemporary thrombolytic thrapy. Results from the GUST-1 trial. Global utilization of streptokinase and TPA for occluded coronary arteries trial Circulation 94 1826–1833 Occurrence Handle8873656 Occurrence Handle1:STN:280:ByiD38jltFM%3D
DR Thiemann J Coresh SP Schulman G Gerstenblith WJ Oetgen NR Powe (2000) ArticleTitleLack of benefit for intravenous thrombolysis in patients with myocardial infarction who are older than 75 years Circulation 101 2239–2246 Occurrence Handle10811589 Occurrence Handle1:STN:280:DC%2BD3c3ntFyitA%3D%3D
I Watanabe K Nagao S Tani T Ohba K Arima K Ohiwa N Masuda T Anazawa K Kanmatsuse T Kushiro (2004) ArticleTitleRelationship between the generation and the facilitated percutaneous coronary intervention in patients with acute myocardial infarction—analysis based on the fibrinolysis and subsequent transluminal trial Circ J 68 1117–1122 Occurrence Handle15564693 Occurrence Handle10.1253/circj.68.1117
GW Stone D Cox E Garcia BR Brodie MC Morice J Griffin L Mattos AJ Lansky WW O'Neill CL Grines (2001) ArticleTitleNormal flow (TIMI-3) before mechanical reperfusion therapy is an independent determinant of survival in acute myocardial infarction: analysis from the primary angioplasty in myocardial infarction trials Circulation 104 636–641 Occurrence Handle11489767 Occurrence Handle1:STN:280:DC%2BD3Mvktlarsg%3D%3D
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Watanabe, I., Nagao, K., Tani, S. et al. Reperfusion strategy for acute myocardial infarction in elderly patients aged 75 to 80 years. Heart Vessels 21, 236–241 (2006). https://doi.org/10.1007/s00380-005-0897-6
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DOI: https://doi.org/10.1007/s00380-005-0897-6