Factores asociados a mortalidad a 30 días en pacientes mayores de 75 años llevados a cateterismo cardiaco

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Coronary disease is the main cause of death in the world and, in that sense, elderly population are the most affected. Parallel to the growing increase in the population over 75 years, security and efficacy of the percutaneous coronary intervention is questioned in regards to its morbidity and mortality. A cross-sectional study was conducted with patients over 75 years who underwent cardiac catheterization due to acute myocardial infarction with or without ST elevation, unstable angina or left ventricular ejection fraction lower than 40%, in a specialized Cardiology Center in Medellín, Colombia, Cumulative incidence was estimated at 30 days and variables related to mortality were explored. Results 399 individuals were analyzed, with an average age of 80 years (RIQ 6), out of whom 20 died during the hospitalization, and a total of 24 died during the 30 days after the cardiac catheterization, with an estimated mortality at 30 days of 6% (CI 95%, 3.5-8.5). The mean hospital stay was 7 days (range 0-64 days). A relationship between mortality and female gender was found with a prevalence rate (PR) of 2.61 (p = 0.017), with infarction posterior to cardiac catheterization PR 9.77 (p < 0.001) and mechanical complication during the catheterization PR 5.039 (p = 0.003). Also, a PR of 9.25 (p < 0.001) in patients with acute myocardial infarction Killip III and IV. Patients with fatal outcome had a mean pulmonary artery systolic pressure (PASP) of 40 mm Hg and a mean ejection fraction of the left ventricular ejection fraction (LVEF) of 40%, whereas those who survived had a mean PASP of 36 mm HG and a mean LVEF of 47%. Conclusion Cardiac catheterization and coronary intervention have a relatively low mortality rate in the first 30 days and it is comparable to younger individuals who underwent this procedure. Factors associated to an increase in mortality were: score of III or IV in the Killip-Kimball scale, decreased ejection fraction, reinfarction during hospitalization, mechanical complication during cardiac catheterization and female gender. These results suggest that percutaneous coronary intervention can be a safe and efficient method in patients over 75 years of age.




Echeverri Marín, D. A., Coy Barrera, A. F., Bastidas Goyes, A., & Ortiz Uribe, J. C. (2017). Factores asociados a mortalidad a 30 días en pacientes mayores de 75 años llevados a cateterismo cardiaco. Revista Colombiana de Cardiologia, 24(4), 327–333. https://doi.org/10.1016/j.rccar.2016.07.011

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