open access

Vol 66, No 11 (2008)
Other
Published online: 2008-11-27
Submitted: 2012-12-28
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Original article
Left ventricular performance and exercise capacity in patients aged 65 years and older treated by primary coronary angioplasty or conservatively for acute myocardial infarction – a one-year follow-up

Wiesława Pawłowska-Jenerowicz, Wojciech Drewniak, Marek Dąbrowski
Kardiol Pol 2008;66(11):1153-1161.

open access

Vol 66, No 11 (2008)
Other
Published online: 2008-11-27
Submitted: 2012-12-28

Abstract


Background: Elderly patients hospitalised for congestive heart failure (CHF) due to myocardial infarction (MI) have very poor prognosis, particularly if CHF symptoms are caused by left ventricular (LV) systolic dysfunction. Early invasive strategy is considered the best method of preventing post-MI LV dysfunction. The clinical impact of early invasive strategy on prognosis in elderly patients with acute MI has yet to be completely defined because of the poor enrolment of elderly patients in large randomised trials.
Aim: To asses whether treatment of acute MI in patients aged >65 years using percutaneous coronary intervention (PCI) results in significantly better long-term cardiovascular performance in comparison with conservative treatment (CT).
Methods: Our study involved 90 MI patients who underwent diagnostic spiroergometry: 40 patients (mean age 73 years) treated conservatively and 50 (mean age 71 years) by PCI. Echocardiographic examinations and spiroergometric tests were performed at 3-, 6- and 12-month follow-up. Plasma NT-proBNP levels were measured on admission and at 6- and 12-month follow-up.
Results: Echocardiographic and spiroergometric parameters were significantly better in PCI patients in each of the analysed periods and showed significant improvement throughout follow-up (the largest between months 3 and 6). In the CT patients these parameters showed significant improvement only between months 3 and 6. After one year, studied parameters were better in PCI patients (LVESD: 3.1±0.4 vs. 3.5±0.6 cm; p

Abstract


Background: Elderly patients hospitalised for congestive heart failure (CHF) due to myocardial infarction (MI) have very poor prognosis, particularly if CHF symptoms are caused by left ventricular (LV) systolic dysfunction. Early invasive strategy is considered the best method of preventing post-MI LV dysfunction. The clinical impact of early invasive strategy on prognosis in elderly patients with acute MI has yet to be completely defined because of the poor enrolment of elderly patients in large randomised trials.
Aim: To asses whether treatment of acute MI in patients aged >65 years using percutaneous coronary intervention (PCI) results in significantly better long-term cardiovascular performance in comparison with conservative treatment (CT).
Methods: Our study involved 90 MI patients who underwent diagnostic spiroergometry: 40 patients (mean age 73 years) treated conservatively and 50 (mean age 71 years) by PCI. Echocardiographic examinations and spiroergometric tests were performed at 3-, 6- and 12-month follow-up. Plasma NT-proBNP levels were measured on admission and at 6- and 12-month follow-up.
Results: Echocardiographic and spiroergometric parameters were significantly better in PCI patients in each of the analysed periods and showed significant improvement throughout follow-up (the largest between months 3 and 6). In the CT patients these parameters showed significant improvement only between months 3 and 6. After one year, studied parameters were better in PCI patients (LVESD: 3.1±0.4 vs. 3.5±0.6 cm; p
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Keywords

myocardial infarction; elderly; heart failure; percutaneous coronary intervention; conservative treatment

About this article
Title

Original article
Left ventricular performance and exercise capacity in patients aged 65 years and older treated by primary coronary angioplasty or conservatively for acute myocardial infarction – a one-year follow-up

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 66, No 11 (2008)

Pages

1153-1161

Published online

2008-11-27

Bibliographic record

Kardiol Pol 2008;66(11):1153-1161.

Keywords

myocardial infarction
elderly
heart failure
percutaneous coronary intervention
conservative treatment

Authors

Wiesława Pawłowska-Jenerowicz
Wojciech Drewniak
Marek Dąbrowski

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