Breaking News
May 3, 2019 - Vaping and Smoking May Signal Greater Motivation to Quit
May 3, 2019 - Dementia looks different in brains of Hispanics
May 3, 2019 - Short-Staffed Nursing Homes See Drop In Medicare Ratings
May 3, 2019 - Study of teens with eating disorders explores how substance users differ from non-substance users
May 3, 2019 - Scientists develop new video game that may help in the study of Alzheimer’s
May 3, 2019 - Arc Bio introduces Galileo Pathogen Solution product line at ASM Clinical Virology Symposium
May 3, 2019 - Cornell University study uncovers relationship between starch digestion gene and gut bacteria
May 3, 2019 - How to Safely Use Glucose Meters and Test Strips for Diabetes
May 3, 2019 - Anti-inflammatory drugs ineffective for prevention of Alzheimer’s disease
May 3, 2019 - Study tracks Pennsylvania’s oil and gas waste-disposal practices
May 3, 2019 - Creating a better radiation diagnostic test for astronauts
May 3, 2019 - Vegans are often deficient in these four nutrients
May 3, 2019 - PPDC announces seed grants to develop medical devices for children
May 3, 2019 - Study maps out the frequency and impact of water polo head injuries
May 3, 2019 - Research on Reddit identifies risks associated with unproven treatments for opioid addiction
May 3, 2019 - Good smells may help ease tobacco cravings
May 3, 2019 - Medical financial hardship found to be very common among people in the United States
May 3, 2019 - Researchers develop multimodal system for personalized post-stroke rehabilitation
May 3, 2019 - Study shows significant mortality benefit with CABG over percutaneous coronary intervention
May 3, 2019 - Will gene-editing of human embryos ever be justifiable?
May 3, 2019 - FDA Approves Dengvaxia (dengue vaccine) for the Prevention of Dengue Disease in Endemic Regions
May 3, 2019 - Why Tonsillitis Keeps Coming Back
May 3, 2019 - Fighting the opioid epidemic with data
May 3, 2019 - Maggot sausages may soon be a reality
May 3, 2019 - Deletion of ATDC gene prevents development of pancreatic cancer in mice
May 2, 2019 - Targeted Therapy Promising for Rare Hematologic Cancer
May 2, 2019 - Alzheimer’s disease is a ‘double-prion disorder,’ study shows
May 2, 2019 - Reservoir bugs: How one bacterial menace makes its home in the human stomach
May 2, 2019 - Clinical, Admin Staff From Cardiology Get Sneak Peek at Epic
May 2, 2019 - Depression increases hospital use and mortality in children
May 2, 2019 - Vicon and NOC support CURE International to create first gait lab in Ethiopia
May 2, 2019 - Researchers use 3D printer to make paper organs
May 2, 2019 - Viral infection in utero associated with behavioral abnormalities in offspring
May 2, 2019 - U.S. Teen Opioid Deaths Soaring
May 2, 2019 - Opioid distribution data should be public
May 2, 2019 - In the Spotlight: “I’m learning every single day”
May 2, 2019 - 2019 Schaefer Scholars Announced
May 2, 2019 - Podcast: KHN’s ‘What The Health?’ Bye-Bye, ACA, And Hello ‘Medicare-For-All’?
May 2, 2019 - Study describes new viral molecular evasion mechanism used by cytomegalovirus
May 2, 2019 - SLU study suggests a more equitable way for Medicare reimbursement
May 2, 2019 - Scientists discover first gene involved in lower urinary tract obstruction
May 2, 2019 - Researchers identify 34 genes associated with increased risk of ovarian cancer
May 2, 2019 - Many low-income infants receive formula in the first few days of life, finds study
May 2, 2019 - Global study finds high success rate for hip and knee replacements
May 2, 2019 - Taking depression seriously: What is it?
May 2, 2019 - With Head Injuries Mounting, Will Cities Put Their Feet Down On E-Scooters?
May 2, 2019 - Scientists develop small fluorophores for tracking metabolites in living cells
May 2, 2019 - Study casts new light into how mothers’ and babies’ genes influence birth weight
May 2, 2019 - Researchers uncover new brain mechanisms regulating body weight
May 2, 2019 - Organ-on-chip systems offered to Asia-Pacific regions by Sydney’s AXT
May 2, 2019 - Adoption of new rules drops readmission penalties against safety net hospitals
May 2, 2019 - Kids and teens who consume zero-calorie sweetened beverages do not save calories
May 2, 2019 - Improved procedure for cancer-related erectile dysfunction
May 2, 2019 - Hormone may improve social behavior in autism
May 2, 2019 - Alzheimer’s disease may be caused by infectious proteins called prions
May 2, 2019 - Even Doctors Can’t Navigate Our ‘Broken Health Care System’
May 2, 2019 - Study looks at the impact on criminal persistence of head injuries
May 2, 2019 - Honey ‘as high in sugars as table sugar’
May 2, 2019 - Innovations to U.S. food system could help consumers in choosing healthy foods
May 2, 2019 - FDA Approves Mavyret (glecaprevir and pibrentasvir) as First Treatment for All Genotypes of Hepatitis C in Pediatric Patients
May 2, 2019 - Women underreport prevalence and intensity of their own snoring
May 2, 2019 - Concussion summit focuses on science behind brain injury
May 2, 2019 - Booker’s Argument For Environmental Justice Stays Within The Lines
May 2, 2019 - Cornell research explains increased metastatic cancer risk in diabetics
May 2, 2019 - Mount Sinai study provides fresh insights into cellular pathways that cause cancer
May 2, 2019 - Researchers to study link between prenatal pesticide exposures and childhood ADHD
May 2, 2019 - CoGEN Congress 2019: Speakers’ overviews
May 2, 2019 - A new strategy for managing diabetic macular edema in people with good vision
May 2, 2019 - Sagent Pharmaceuticals Issues Voluntary Nationwide Recall of Ketorolac Tromethamine Injection, USP, 60mg/2mL (30mg per mL) Due to Lack of Sterility Assurance
May 2, 2019 - Screen time associated with behavioral problems in preschoolers
May 2, 2019 - Hormone reduces social impairment in kids with autism | News Center
May 2, 2019 - Researchers synthesize peroxidase-mimicking nanozyme with low cost and superior catalytic activity
May 2, 2019 - Study results of a potential drug to treat Type 2 diabetes in children announced
May 2, 2019 - Multigene test helps doctors to make effective treatment decisions for breast cancer patients
May 2, 2019 - UNC School of Medicine initiative providing unique care to dementia patients
May 2, 2019 - Nestlé Health Science and VHP join forces to launch innovative COPES program for cancer patients
May 2, 2019 - Study examines how our brain generates consciousness and loses it during anesthesia
May 2, 2019 - Transition Support Program May Aid Young Adults With Type 1 Diabetes
May 2, 2019 - Study shows how neutrophils exacerbate atherosclerosis by inducing smooth muscle-cell death
May 2, 2019 - Research reveals complexity of how we make decisions
Opening blocked arteries may be lifesaver for older heart attack patients

Opening blocked arteries may be lifesaver for older heart attack patients

Among heart attack patients 75 years and older, the oldest of those patients were less likely than younger patients to receive a procedure to open blocked arteries. But, older patients were more likely to survive heart attacks if they had the procedure, called percutaneous coronary intervention, or PCI, according to a new research letter in Circulation: Cardiovascular Interventions, an American Heart Association journal.

Adults 75 years and older are a fast-growing age group, expected to make up 11.5 percent of the U.S. population by 2050. Yet, relatively little is known about whether it’s beneficial to perform PCI in these patients. PCI, also known as an angioplasty and coronary stenting, is a medical procedure in which a catheter with a deflated balloon on its tip is passed into the narrowed artery segment, the balloon is inflated and the narrowed segment widened. Then, the balloon is deflated, a stent is deployed at the site of the narrow segment, and the catheter is removed.

“We know that PCI is safe, feasible and improves overall survival and well-being in younger adults who have a heart attack,” said study author Abdulla A. Damluji, M.D., M.P.H., an Assistant Professor at Johns Hopkins University School of Medicine in Baltimore, Maryland and an Interventional Cardiologist at Sinai Hospital of Baltimore, LifeBridge Health in Maryland. “But older adults tend to have more complex medical needs, and live with geriatric syndromes like frailty, multiple chronic conditions, cognitive impairment and use multiple medications. Because of these intricacies, they are systematically excluded from clinical trials to test therapies including PCI. As such, the evidence on whether or not such treatment works in older adults has not been fully evaluated.”

Damluji and colleagues studied medical records of nearly 470,000 older patients admitted to U.S. hospitals with a first heart attack from 2000 to 2016. They grouped patients 75 to 79 years as “young-old,” 80 to 84 as “middle-old” and 85 and older as “old-old.”

They found:

  • The 85-and-older group were most likely to have other diseases when admitted for their first heart attack. They also were most likely to die in the hospital, at a rate of 13 percent, versus the youngest group of which 8 percent died in the hospital.
  • PCI was performed in 38 percent of 75- to 79-year-old group, 33 percent of the 80- to 84-year-old group and 20 percent of 85-and-older heart attack patients.
  • PCI use among 85-and-older first-time heart attack patients increased sharply over time from 10 percent in 2000 to 25 percent in 2016. Risk of death for these patients fell over time, from 17 percent in 2000 to 11 percent in 2016.
  • There was a 53 percent reduction in overall death among the 75- to 79-year-olds in the PCI group compared to the group that did not have the procedure. The reduction in death with PCI was 49 percent among those 80 to 84 and 42 percent reduction among 85-and-older. That means that for every 1,000 cases, lives were saved for 49 young-olds, 53 middle-olds and 54 old-olds.

“We are attempting PCI in the very old patient population more and more over time, and even though this is a complex patient population and PCI is an invasive intervention, it appears that the life-saving benefit is substantial,” Damluji said.

“Determining through a futility assessment when a procedure should not be done remains a critical challenge” said Mauro Moscucci, M.D., M.B.A., senior author of the study and Chairman of Medicine at Sinai Hospital of Baltimore, LifeBridge Health in Maryland. “Futile procedures are procedures that are not expected to change the outcome. They can even result in worse outcomes due to unexpected complications.”

A limitation of this work is it is not a clinical trial; rather, it shows an association between PCI and survival in very old adults over 85 years of age and admitted with heart attack.

“In order to have a sound conclusion about the effectiveness of PCI in this population, future clinical trials should enroll older adults even if they have complexities such as frailty, multiple chronic conditions cognitive dysfunction and multiple medications,” Damluji said.

Source:

https://newsroom.heart.org/news/unblocking-arteries-after-heart-attack-may-be-lifesaver-for-older-patients?preview=1eb27198aaa643e81f2baf4bc48ff23e

Tagged with:

About author

Related Articles