scholarly journals Time trends in risk factor control and use of secondary preventive medication among patients with myocardial infarction attending cardiac rehabilitation: data from the SWEDEHEART registry 2006–2017

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Leosdottir ◽  
E Hagstrom ◽  
N Hadziosmanovic ◽  
A Norhammar ◽  
B Lindahl ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Risk Factor ◽  
Cardiac Rehabilitation ◽  
Central Obesity ◽  
Risk Factor Control ◽  
Time Period ◽  
Preventive Medication ◽  
Euroaspire Iii ◽  
One Year

Abstract Background Systematically monitoring results within cardiac rehabilitation (CR) has been highlighted as a possible way to improve CR outcomes. The nationwide SWEDEHEART registry has monitored quality of care post myocardial infarction (MI) in Sweden since the 1990s. Follow-up data describing treatment and outcomes within CR has been collected since 2006. Purpose To describe changes in risk factor control and use of secondary preventive medication for post MI patients after completion of CR in Sweden 2006–2017, and to compare with trends in the EUROASPIRE surveys. Methods All patients who suffered an MI and attended a one-year CR follow-up visit registered in SWEDEHEART 2006–2017 were included (n=66 666, 18–74 years, 75% men). Trends in risk factor control and secondary preventive medication were collected yearly and analyzed over the time period using Cochran-Armitage trend test. Comparisons were made to data from the EUROASPIRE III (2006–2007), IV (2012–2013) and V (2016–2017) surveys, where patients with coronary artery events or interventions were interviewed at approximately 1.2 years after the index event (n=25 225, 18–80 years, 74% men). Results Trends in blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) control, smoking, and central obesity are shown in the Figure. The proportion of patients achieving BP goal <140/90 mmHg and LDL-C goal <1.8 mmol/L increased by 16% and 29% from 2006 to 2017 in SWEDEHEART (p for trend <0.0001 for both), compared to 14% and 8% between EUROASPIRE III and V. Of patients who were active smokers at the time of the index event, the proportion still smoking at one-year remained unchanged in SWEDEHEART (43% in 2006 and 2017) while increasing from 52% to 55% in the EUROASPIRE surveys. An increase in prevalence of central obesity from approximately 50% to 60% was observed in both cohorts. The proportion of patients with obesity (BMI ≥30kg/m2) and diabetes increased in SWEDEHEART during the observed period from 23% to 29% (obesity) and 18% to 25% (diabetes) (p for trend <0.0001 for both). The proportions in 2017 were considerably lower than in EUROASPIRE V (2016–2017), where 38% were obese and 29% had diabetes. The use of statins increased from 89% to 93%, ezetimibe from 5% to 21%, and ACE/ARB from 65% to 82% in SWEDEHEART (p for trend <0.0001 for all). In comparison, in EUROASPIRE V the proportion treated with lipid lowering medication of any kind was 84% and with ACE/ARB was 75%. Conclusion Between 2006–2017, considerable improvements were achieved in risk factor control and use of secondary preventive medication for MI patients completing CR in Sweden, where all patients were monitored through the SWEDEHEART registry. The improvements were larger than observed in the EUROASPIRE surveys during the same time period. Continuous and nationwide auditing of CR outcomes, as well as local review of performance, could be possible explanations for some of the observed differences. Figure 1 Funding Acknowledgement Type of funding source: None

Long-term effects of an intensive prevention program (IPP) after acute myocardial infarction – the IPP Follow-up and Prevention Boost Trial

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Wienbergen ◽  
A Fach ◽  
S Meyer ◽  
J Schmucker ◽  
R Osteresch ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Risk Factor ◽  
Prevention Program ◽  
Study Endpoint ◽  
Funding Source ◽  
Risk Factor Control ◽  
One Year

Abstract Background The effects of an intensive prevention program (IPP) for 12 months following 3-week rehabilitation after myocardial infarction (MI) have been proven by the randomized IPP trial. The present study investigates if the effects of IPP persist one year after termination of the program and if a reintervention after >24 months (“prevention boost”) is effective. Methods In the IPP trial patients were recruited during hospitalization for acute MI and randomly assigned to IPP versus usual care (UC) one month after discharge (after 3-week rehabilitation). IPP was coordinated by non-physician prevention assistants and included intensive group education sessions, telephone calls, telemetric and clinical control of risk factors. Primary study endpoint was the IPP Prevention Score, a sum score evaluating six major risk factors. The score ranges from 0 to 15 points, with a score of 15 points indicating best risk factor control. In the present study the effects of IPP were investigated after 24 months – one year after termination of the program. Thereafter, patients of the IPP study arm with at least one insufficiently controlled risk factor were randomly assigned to a 2-months reintervention (“prevention boost”) vs. no reintervention. Results At long-term follow-up after 24 months, 129 patients of the IPP study arm were compared to 136 patients of the UC study arm. IPP was associated with a significantly better risk factor control compared to UC at 24 months (IPP Prevention Score 10.9±2.3 points in the IPP group vs. 9.4±2.3 points in the UC group, p<0.01). However, in the IPP group a decrease of risk factor control was observed at the 24-months visit compared to the 12-months visit at the end of the prevention program (IPP Prevention Score 10.9±2.3 points at 24 months vs. 11.6±2.2 points at 12 months, p<0.05, Figure 1). A 2-months reintervention (“prevention boost”) was effective to improve risk factor control during long-term course: IPP Prevention Score increased from 10.5±2.1 points to 10.7±1.9 points in the reintervention group, while it decreased from 10.5±2.1 points to 9.7±2.1 points in the group without reintervention (p<0.05 between the groups, Figure 1). Conclusions IPP was associated with a better risk factor control compared to UC during 24 months; however, a deterioration of risk factors after termination of IPP suggests that even a 12-months prevention program is not long enough. The effects of a short reintervention after >24 months (“prevention boost”) indicate the need for prevention concepts that are based on repetitive personal contacts during long-term course after coronary events. Figure 1 Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Stiftung Bremer Herzen (Bremen Heart Foundation)

Abstract 278: The China Patient-Centered Evaluative Assessment of Cardiac Events (PEACE) Prospective Study of Acute Myocardial Infarction: Study Design

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Jing Li ◽  
Rachel P Dreyer ◽  
Xi Li ◽  
Xue Du ◽  
Nicholas S Downing ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Risk Factor ◽  
Prospective Study ◽  
Patient Experience ◽  
Risk Factor Control

Background: The incidence of acute myocardial infarction (AMI) is growing rapidly in China, but there is limited information about the patient experience in the post-acute period. Specifically, long-term outcomes and patient-reported outcomes (PROs), including quality of life, symptoms and mood, after AMI, have not been systematically studied in China. Objectives: To conduct a nationwide prospective study following patients after AMI that 1) measures long-term clinical outcomes, PROs, cardiovascular risk factor control and adherence to medications for secondary prevention; and 2) identifies patient characteristics and hospital attributes that are associated with these outcomes. Methods: The China PEACE Prospective Study of AMI has recruited 4000 consecutive patients from 55 hospitals across China and is following them for 1-year. The first patient was enrolled in December 2012, and the last follow-up visit is scheduled for June 2015. After obtaining informed consent from patients, we abstracted details of their medical history, treatment, and in-hospital outcomes from medical charts. We conducted comprehensive baseline interviews characterizing patient demographics, risk factors, clinical presentation, and healthcare utilization. In addition, we used validated PRO instruments to measure quality of life, symptoms, mood, sleep, cognition and sexual activity. Follow-up interviews, measuring PROs, medication adherence and risk factor control were conducted at 1-, 6-, and 12-months after discharge. At these interviews, patients were asked to self-report major health events and to provide supporting materials (e.g., hospital discharge record for a readmission), which were subsequently validated by a National Coordinating Center. Blood and urine samples were obtained at baseline and 12-month follow-up, and stored for further biomarker analysis and genetic studies. To complement these patient-level data, we surveyed participating hospitals to characterize their facilities, processes and organizational learning culture. Together, these data will be used to identify factors associated with various outcomes following AMI. Conclusion: This study is uniquely positioned to generate new information regarding patient experience and determinants of outcomes after AMI in China.

scholarly journals Managed Care after Acute Myocardial Infarction (MC-AMI) Reduces Total Mortality in 12-Month Follow-Up—Results from a Poland’s National Health Fund Program of Comprehensive Post-MI Care—A Population-Wide Analysis

2020 ◽  
Vol 9 (10) ◽  
pp. 3178
Author(s):  
Krystian Wita ◽  
Andrzej Kułach ◽  
Jacek Sikora ◽  
Joanna Fluder ◽  
Ewa Nowalany-Kozielska ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Managed Care ◽  
Cardiac Rehabilitation ◽  
National Health ◽  
Cox Regression ◽  
Mortality Reduction ◽  
Health Fund ◽  
One Year

Introduction: Advances in the acute treatment of myocardial infarction (AMI) substantially reduced in-hospital mortality, but the post-discharge prognosis is still unacceptable. The Managed Care in Acute Myocardial Infarction (MC-AMI) is a program of Poland’s National Health Fund that aims at comprehensive post-AMI care to improve long-term prognosis. The aim of the study was to assess the effect of MC-AMI on all-cause mortality in one-year follow-up. Methods: MC-AMI includes acute MI treatment, complex revascularization, cardiac rehabilitation (CR), scheduled one-year outpatient follow-up, and prevention of sudden cardiac death. In this retrospective observational study performed in a province of Silesia, Poland, we analyzed 3893 MC-AMI participants, and compared them to 6946 patients in the control group. After propensity score matching, we compared two groups of 3551 subjects each. To assess the effect of MC-AMI and other variables on mortality, we preformed a Cox regression. Results: MC-AMI was related with mortality reduction by 38% in a 12-month observation period and the effect persisted even after. Multivariable Cox regression analysis revealed MC-AMI participation to be inversely associated with 1-year mortality (HR 0.52, 95%CI 0.42–0.65, p < 0.001). Besides that, older age (HR 1.47/10 y), ST-elevation AMI (HR 1.41), heart failure (HR 2.08), diabetes (HR 1.52), and dialysis (HR 2.38) were significantly associated with the primary endpoint. Among MC-AMI components, cardiac rehabilitation (HR 0.34) and strict outpatient care (HR 0.42) are the crucial factors affecting mortality reduction. Conclusions: Participation in MC-AMI reduced 1-year mortality by 38% and the effect persisted after the program had been completed.

Impact of cardiac rehabilitation referral on one-year outcome after discharge of patients with acute myocardial infarction

2018 ◽  
Vol 26 (2) ◽  
pp. 138-144 ◽  
Author(s):  
Matthias Hermann ◽  
Fabienne Witassek ◽  
Paul Erne ◽  
Hans Rickli ◽  
Dragana Radovanovic
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Rehabilitation ◽  
St Elevation Myocardial Infarction ◽  
Multivariable Logistic Regression Analysis ◽  
St Elevation ◽  
One Year ◽  
Lost To Follow Up ◽  
The Impact

Background Cardiac rehabilitation after an acute myocardial infarction has a class I recommendation in the present guidelines. However, data about the impact on mortality in Switzerland are not available. Therefore, we analysed one-year outcome of acute myocardial infarction patients according to cardiac rehabilitation referral at discharge. Design and methods Data were extracted from the Swiss AMIS Plus registry and included patients with ST-elevation myocardial infarction and non-ST-elevation myocardial infarction, who were asked to give their informed consent to a telephone follow-up one year after discharge. Results From 10,141 patients, 1956 refused to participate in follow-up and 302 were lost to follow-up. There were 4508 (57.2%) patients with cardiac rehabilitation referrals compared with 3375 (42.8%) without. Patients referred to cardiac rehabilitation were younger (62.4 years vs. 68.8 years), more often male (77% vs. 70%), presented more often with ST-elevation myocardial infarction (63.5% vs. 52.1%) and, apart from smoking (44.0% vs. 34.9%), they had fewer risk factors, such as dyslipidaemia (55.0% vs. 60.1%), hypertension (55.6% vs. 65.3%) and diabetes (16.7% vs. 21.5%). Patients referred to cardiac rehabilitation had a lower crude one-year all-cause mortality (1.7% vs. 5.8%; p < 0.001) and lower rates of re-infarction, rehospitalization for cardiovascular disease and intervention (all p < 0.005). In a multivariable logistic regression analysis, cardiac rehabilitation was an independent predictor for lower mortality rate (odds ratio 0.65; 95% confidence interval 0.48–0.89; p = 0.007). Conclusions Although the detailed data of cardiac rehabilitation programmes and patient participation were not available for this study, our data from 7883 acute myocardial infarction patients showed a better one-year outcome for patients with cardiac rehabilitation referrals than for those without.

scholarly journals Organizational and patient-level predictors for reaching key risk factor targets in cardiac rehabilitation after myocardial infarction – the perfect-CR study

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
H Ogmundsdottir Michelsen ◽  
P Henriksson ◽  
J Wallert ◽  
M Back ◽  
I Sjolin ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Risk Factor ◽  
Cardiac Rehabilitation ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Smoking Abstinence ◽  
Organizational Variables ◽  
Patient Level ◽  
One Year

Abstract Background The benefits of specific cardiac rehabilitation (CR) programme components on patient outcomes after myocardial infarction (MI) remain unclear, as does their relative predictive strength compared to patient-level predictors. Purpose To identify CR organizational and patient-level predictors for reaching risk factor targets at one-year post-MI. Methods This was an observational survey- and registry-based study. Data on CR organization at all 78 CR centres in Sweden was collected in 2016 and merged with individual patient data from nationwide registries (n=7549, median age 64 years, 24% females). Cross-validation resampled orthogonal partial least squares discriminant analysis identified predictors for reaching treatment targets for low-density lipoprotein-cholesterol (LDL-C&lt;1.8 mmol/L), blood pressure (BP&lt;140/90 mmHg) and smoking abstinence (yes/no). Predictors with Variables of Importance for the Projection (VIP) value &gt;0.8 and 95% confidence intervals (CI) excluding zero, were considered meaningful. Results Of the 71 analysed organizational variables, 36 were identified as meaningful predictors for reaching LDL-C and 35 for BP targets (Figure 1). The strongest predictors (VIP [95% CI]) for LDL-C and BP were: offering psychosocial management at initial CR assessment 2.09 [1.70–2.49]; 2.34 [1.90–2.78], having a CR team psychologist 1.59 [1.28–1.91]; 2.00 [1.46–2.55], having extended CR centre opening hours 2.17 [1.95–2.40]; 1.51 [1.03–2.00], staff reporting satisfaction with CR centre facilities 1.55 [1.07–2.04]; 1.96 [1.64–2.28], having a medical director 1.71 [1.45–1.97]; 1.47 [1.07–1.87], nurses using protocols for antihypertensive and/or lipid lowering medication adjustment 1.58 [1.35–1.81]; 1.56 [1.03–2.08], having operational team meetings 1.36 [1.08–1.64]; 1.34 [0.99–1.70], and using audit data for quality improvement 1.00 [0.79–1.20]; 1.27 [0.99–1.56]. Offering pre-exercise-based CR (exCR) assessment and different modes of exCR were predictors for reaching both targets. The strongest patient-level predictor of reaching LDL-C target was low baseline LDL-C 3.90 [3.25–4.56], and for BP it was having no history of hypertension 2.93 [2.74–3.12]. Second, participation in exCR was the strongest predictor for both outcomes 1.60 [0.83–2.37]; 1.50 [1.15–1.86]. For smoking abstinence, 5 organizational variables were identified as meaningful predictors, the strongest being prescription of varenicline by the centre physicians 1.98 [0.13–3.84] (Figure 2). The strongest patient-level predictors were exCR participation 2.51 [2.24–2.79] and socioeconomic status variables e.g., income 1.67 [1.28–2.06], living with partner 1.47 [0.84–2.09] and education 0.80 [0.48–1.12]. Conclusion The study identified multiple CR organizational and patient-level predictors for reaching key risk factor targets one-year post-MI. The results might contribute to defining the optimal composition of comprehensive CR programmes. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): 1) The Swedish Research Council for Health, Working Life and Welfare (FORTE)2) The Swedish Heart and Lung Foundation (Hjärt Lung Fonden)

scholarly journals Relationship between risk factor control and vascular events in the SAMMPRIS trial

Neurology ◽  
2016 ◽  
Vol 88 (4) ◽  
pp. 379-385 ◽  
Author(s):  
Tanya N. Turan ◽  
Azhar Nizam ◽  
Michael J. Lynn ◽  
Brent M. Egan ◽  
Ngoc-Anh Le ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Myocardial Infarction ◽  
Blood Pressure ◽  
Risk Factor ◽  
Recurrent Stroke ◽  
Density Lipoprotein ◽  
Vascular Events ◽  
Risk Factor Control

Objective:The Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) study is the first stroke prevention trial to include protocol-driven intensive management of multiple risk factors. In this prespecified analysis, we aimed to investigate the relationship between risk factor control during follow-up and outcome of patients in the medical arm of SAMMPRIS.Methods:Data from SAMMPRIS participants in the medical arm (n = 227) were analyzed. Risk factors were recorded at baseline, 30 days, 4 months, and then every 4 months for a mean follow-up of 32 months. For each patient, values for all risk factor measures were averaged and dichotomized as in or out of target.Results:Participants who were out of target for systolic blood pressure and physical activity, as well as those with higher mean low-density lipoprotein cholesterol and non–high-density lipoprotein, were more likely to have a recurrent vascular event (stroke, myocardial infarction, or vascular death) at 3 years compared to those who had good risk factor control. In the multivariable analysis, greater physical activity decreased the likelihood of a recurrent stroke, myocardial infarction, or vascular death (odds ratio 0.6, confidence interval 0.4–0.8).Conclusions:Raised blood pressure, cholesterol, and physical inactivity should be aggressively treated in patients with intracranial atherosclerosis to prevent future vascular events. Physical activity, which has not received attention in stroke prevention trials, was the strongest predictor of a good outcome in the medical arm in SAMMPRIS.ClinicalTrials.gov identifier:NCT00576693.

Feasibility of hybrid telerehabilitation as component of a novel comprehensive care program after acute myocardial infarction in a one-year follow-up preliminary experience of a single center

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
E Piotrowicz ◽  
P Orzechowski ◽  
I Kowalik ◽  
R Piotrowicz
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Acute Myocardial Infarction ◽  
Heart Rate ◽  
Functional Capacity ◽  
Care Program ◽  
Comprehensive Care ◽  
Monitoring Center ◽  
One Year

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): National Health Fund Background. A novel comprehensive care program after acute myocardial infarction (AMI) „KOS-zawał" was implemented in Poland. It includes acute intervention, complex revascularization, implantation of cardiovascular electronic devices (in case of indications), rehabilitation or hybrid telerehabilitation (HTR) and scheduled outpatient follow-up. HTR is a unique component of this program. The purpose of the pilot study was to evaluate a feasibility, safety and patients’ acceptance of HTR as component of a novel care program after AMI and to assess mortality in a one-year follow-up. Methods The study included 55 patients (LVEF 55.6 ± 6.8%; aged 57.5 ± 10.5 years). Patients underwent a 5-week HTR based on Nordic walking, consisting of an initial stage (1 week) conducted within an outpatient center and a basic stage (4-week) home-based telerehabilitation five times weekly. HTR was telemonitored with a device adjusted to register electrocardiogram (ECG) recording and to transmit data via mobile phone network to the monitoring center. The moments of automatic ECG registration were pre-set and coordinated with exercise training. The influence on physical capacity was assessed by comparing changes in functional capacity (METs) from the beginning and the end of HTR. Patients filled in a questionnaire in order to assess their acceptance of HTR at the end of telerehabilitation. Results HTR resulted in a significant improvement in functional capacity and workload duration in exercise test (Table). Safety: there were neither deaths nor adverse events during HTR. Patients accepted HTR, including the need for interactive everyday collaboration with the monitoring center. Prognosis all patients survived in a one-year follow-up. Conclusions Hybrid telerehabilitation is a feasible, safe form of rehabilitation, well accepted by patients. There were no deaths in a one-year follow-up. Outcomes before and after HTR Before telerehabilitation After telerehabilitation P Exercise time [s] 381.5 ± 92.0 513.7 ± 120.2 &lt;0.001 Maximal workload [MET] 7.9 ± 1.8 10.1 ± 2.3 &lt;0.001 Heart rate rest [bpm] 68.6 ± 12.0 66.6 ± 10.9 0.123 Heart rate max effort [bpm] 119.7 ± 15.9 131.0 ± 20.1 &lt;0.001 SBP rest [mmHg] 115.6 ± 14.8 117.7 ± 13.8 0.295 DBP rest [mmHg] 74.3 ± 9.2 76.2 ± 7.3 0.079 SBP max effort [mm Hg] 159.5 ± 25.7 170.7 ± 25.5 0.003 DBP max effort [mm Hg] 84.5 ± 9.2 87.2 ± 9.3 0.043 SBP systolic blood pressure, DBP diastolic blood pressure.

The current treatment and predictors of outcome in elderly patients with non-ST-elevation myocardial infarction in an all comers population: the POPular Age registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M.E Gimbel ◽  
D.R.P.P Chan Pin Yin ◽  
R.S Hermanides ◽  
F Kauer ◽  
A.H Tavenier ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Elderly Patients ◽  
Major Bleeding ◽  
Oral Anticoagulation ◽  
Dual Antiplatelet Therapy ◽  
Bleeding Risk ◽  
Cardiovascular Death ◽  
St Elevation ◽  
One Year

Abstract Background Elderly patients form a large and growing part of the patients presenting with non-ST-elevation myocardial infarction (NSTEMI). Choosing the optimal antithrombotic treatment in these elderly patients is more complicated because they frequently have characteristics indicating both a high ischaemic and high bleeding risk. Purpose We describe the treatment of elderly patients (&gt;75 years) admitted with NSTEMI, present the outcomes (major adverse cardiovascular events (MACE) and bleeding) and aim to find predictors for adverse events. Methods The POPular AGE registry is an investigator initiated, prospective, observational, multicentre study of patients aged 75 years or older presenting with NSTEMI. Patients were recruited between August 1st, 2016 and May 7th, 2018 at 21 sites in the Netherlands. The primary composite endpoint of MACE included cardiovascular death, non-fatal myocardial infarction and non-fatal stroke at one-year follow-up. Results A total of 757 patients were enrolled. During hospital stay 76% underwent coronary angiography, 34% percutaneous coronary intervention and 12% coronary artery bypass grafting (CABG). At discharge 78.6% received aspirin (non-users mostly because of the combination of oral anticoagulant and clopidogrel), 49.7% were treated with clopidogrel, 34.2% with ticagrelor and 29.6% were prescribed oral anticoagulation. Eighty-three percent of patients received dual antiplatelet therapy (DAPT) or dual therapy consisting of oral anticoagulation and at least one antiplatelet agent for a duration of 12 months. At one year, the primary outcome of cardiovascular death, myocardial infarction or stroke occurred in 12.3% of patients and major bleeding (BARC 3 or 5) occurred in 4.8% of the patients. The risk of MACE and major bleeding was highest during the first month and stayed high over time for MACE while the risk for major bleeding levelled off. Independent predictors for MACE were age, renal function, medical history of CABG, stroke and diabetes. The only independent predictor for major bleeding was haemoglobin level on admission. Conclusion In this all-comers registry, most elderly patients (≥75 years) with NSTEMI are treated with DAPT and undergoing coronary angiography the same way as younger NSTEMI patients from the SWEDEHEART registry. Aspirin use was lower as was the use of the more potent P2Y12 inhibitors compared to the SWEDEHEART which is very likely due to the concomitant use of oral anticoagulation in 30% of patients. The fact that ischemic risk stays constant over 1 year of follow-up, while the bleeding risk levels off after one month may suggest the need of dual antiplatelet therapy until at least one year after NSTEMI. Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): AstraZeneca

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