Effects of intracoronary injection of nicorandil and tirofiban on myocardial perfusion and short-term prognosis in elderly patients with acute ST-segment elevation myocardial infarction after emergency PCI

Background: Doing percutaneous coronary intervention (PCI) in the first hours of myocardial infraction (MI) is effective in re-establishment of blood flow. Anticoagulation treatment should be prescribed in patients undergoing PCI to decrease the side effects of ischemia. The aim of this study is to determine the effect of heparin prescription after PCI on short-term clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI). Materials: This randomized clinical trial study was conducted at Imam Ali cardiovascular center at Kermanshah university of medical science (KUMS), Iran. Between April 2019 to October 2019, 400 patients with STEMI which candidate to PCI were enrolled. Patients randomly divided in two groups: intervention group (received 5,000 units of heparin after PCI until first 24 hours, every 6 hours) and control group (did not receive heparin). Data were collected using a checklist developed based on the study's aims. Differences between groups were assessed using independent t-tests and chi-square (or Fisher exact tests).Result: Observed that, mean prothrombin time (PT) (13.30±1.60 vs. 12.21±1.15, p<0.001) and partial thromboplastin time (PTT) (35.30±3.08 vs. 34.41±3.01, p=0.003) were significantly higher in intervention group compared to control group. Thrombolysis in myocardial infarction (TIMI) flow grade 0/1 after primary PCI was significantly more frequently in control group (5.5% vs. 1.0%, p=0.034). The mean of ejection fraction (EF) after PCI (47.58±7.12 vs. 45.15±6.98, p<0.001) was significantly higher in intervention group. Intervention group had a statistically significant shorter length of hospital stay (4.71±1.03 vs. 6.12±1.10, p<0.001). There was higher incidence of re-vascularization (0% vs. 3.0%; p=0.013) and re-MI (0% vs. 2.5%; p=0.024) in the control group.Conclusion: Performing primary PCI with receiving heparin led to improve TIMI flow and consequently better EF. Receiving heparin is associated with lower risk of re-MI and re-vascularization.

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Comparison of epidemiology, treatments and outcomes of ST segment elevation myocardial infarction between young and elderly patients

Emergency Medicine Journal ◽

10.1136/emermed-2017-206754 ◽

2018 ◽

pp. emermed-2017-206754

Author(s):

Pin Pin Pek ◽

Huili Zheng ◽

Andrew Fu Wah Ho ◽

Win Wah ◽

Huay Cheem Tan ◽

...

Keyword(s):

Myocardial Infarction ◽

Elderly Patients ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

St Segment

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The effects of percutaneous coronary intervention on mortality in elderly patients with non-ST-segment elevation myocardial infarction undergoing coronary angiography

Scottish Medical Journal ◽

10.1177/0036933020919931 ◽

2020 ◽

Vol 65 (3) ◽

pp. 81-88

Author(s):

Pınar D Gündoğmuş ◽

Emrah B Ölçü ◽

Ahmet Öz ◽

İbrahim H Tanboğa ◽

Ahmet L Orhan

Keyword(s):

Myocardial Infarction ◽

Percutaneous Coronary Intervention ◽

Coronary Angiography ◽

Elderly Patients ◽

Coronary Intervention ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

St Segment ◽

Percutaneous Coronary ◽

One Year

Introduction Although it is recommended that elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI) should undergo an assessment for invasive revascularization, these patients undergo fewer coronary interventions despite the current guidelines. The aim of the study is to evaluate the effectiveness of percutaneous coronary intervention on all-cause mortalities monthly and annually in the population. Methods Three hundred and twenty-four patients with NSTEMI aged 65 years or older who underwent coronary angiography and treated with conservative strategy or percutaneous coronary intervention were included in the study. All demographic and clinical characteristics of the patients were recorded and one-month and one-year follow-up results were analysed. Results Two hundred eight cases (64.19%) were treated with percutaneous coronary intervention and 116 cases (35.81%) of the participant were treated with conservative methods. The mean age of the participants was 75.41 ± 6.65 years. The treatment strategy was an independent predictor for the mortality of one-year (HR: 1.965). Furthermore, Killip class ≥2 (HR:2.392), Left Ventricular Ejection Fraction (HR:2.637) and renal failure (HR: 3.471) were independent predictors for one-year mortality. Conclusion The present study has revealed that percutaneous coronary intervention was effective on one-year mortality in NSTEMI patients over the age of 65. It is considered that percutaneous coronary intervention would decrease mortality in these patients but it should be addressed in larger population studies.

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