MODERN ASPECTS OF MYOCARDIAL INFARCTION TREATMENT IN OLDER PATIENTS

Abstract


In this study, the authors attempted to systematize current information based on recommendations, large studies and meta-analyzes of the treatment of myocardial infarction in the elderly. Cardiovascular heart disease represents the leading cause of death in people aged 65 years and over. Acute myocardial infarction is one of the most socially important diseases with a high rate of mortality and disability. In elderly and old patients atypical forms of myocardial infarction are common. High rate of comorbidities, functional and socioeconomic status, side effects associated with drug administration create difficulty in the diagnosis and selection of treatment in the elderly. These patients need a prolonged monitoring with using an additional examinations and dynamic observation. Compared to younger subjects, elderly patients with acute myocardial infarction are less likely to receive evidence-based treatment, including myocardial revascularization therapy. Endovascular revascularization is currently the main standard for the treatment of acute myocardial infarction, but the advantage of the use of interventional cardiology techniques in elderly patients has been insufficiently studied. Older patients are generally underrepresented in cardiovascular trials. Modern scientific literature, illuminating issues of application of pharmacological and endovascular treatment of acute myocardial infarction in elderly and old age patients, contains fragmented and, in some cases, contradictory data, which forces researchers to continue studying new and promising methods of diagnosis and treatment of myocardial infarction in the elderly.


About the authors

Kirill L. Kozlov

Saint Petersburg Institute of Bioregulation and Gerontology Research Center, Saint Petersburg, Russia; Military Medical Academy, Saint Petersburg, Russia

Author for correspondence.
Email: kozlov_kl@mail.ru

Russian Federation, 197110 Russia, Saint Petersburg, Dynamo Ave., 3; 194044, Saint Petersburg, 6 Akademika Lebedeva street, Litera. " V»

Doctor of medicine, Professor, Deputy director for educational and methodological work

Andrey N. Bogomolov

Saint Petersburg Institute of Bioregulation and Gerontology Research Center, Saint Petersburg, Russia

Email: endovsurg@gmail.com

Russian Federation, 197110 Russia, Saint Petersburg, Dynamo Ave.,

Ph.D. in Medicine, Senior Researcher of the Laboratory of Age-Related Pathology of the Cardiovascular System of the Department of Clinical Gerontology and Geriatrics

Nikolay G. Lukianov

Military Medical Academy, Saint Petersburg, Russia

Email: loncori001@rambler.ru

Russian Federation, 194044, Saint Petersburg, 6 Akademika Lebedeva street, Litera. " V»

Ph.D. in Medicine, Associate Professor, Associate Professor of the 1st department (surgery for advanced medical doctors) named after P.A. Kupriyanov, S.M. Kirov

Ekaterina I. Senkina

Saint Petersburg Institute of Bioregulation and Gerontology Research Center, Saint Petersburg, Russia

Email: 5436588@gmail.com

Russian Federation, 197110 Russia, Saint Petersburg, Dynamo Ave.,

Researcher of the Laboratory of Age-Related Pathology of the Cardiovascular System

Anastasia E. Pukhalskaya

Saint Petersburg Institute of Bioregulation and Gerontology Research Center, Saint Petersburg, Russia

Email: nastyapuh96@mail.ru

Russian Federation, 197110 Russia, Saint Petersburg, Dynamo Ave.,

Researcher of the Laboratory of Age-Related Pathology of the Cardiovascular System

References

  1. Kozlov K, Shanin V. Ischemic heart disease. Saint-Petersburg: JeLBI-SPb; 2015.
  2. Bogachev A, Kozlov K, Oleksyuk I. Coronary revascularization versus optimal medical therapy in elderly patients with stable angina. Advances in Gerontology. 2012; 2 (3): 261-7. PMID: 22550874.
  3. Robinson M. Global health and global aging. San Francisco: Jossey-Bass; 2007. ISBN: 978-0-470-17583-5.
  4. Tavrovskaja T, Kachesova A, Sokolova O. Myocardial infarction: thrombolysis, hospital mortality, myocardial rupture. Journal of arrhythmology. 2008; 51: 28-35.
  5. Alexander K, Newby L, Armstrong P. ST-Segment–Elevation Myocardial Infarction: A Scientific Statement for Healthcare Professionals From the American Heart Association Council on Clinical Cardiology: In Collaboration With the Society of Geriatric Cardiology. Circulation. 2007; (115): 2570-89. doi: 10.1161/CIRCULATIONAHA.107.182616.
  6. Fernández-Bergés D, Félix-Redondo F, Consuegra-Sánchez L, et al. Infarto de miocardio en mayores de 75 años: una población en aumento. Estudio CASTUO. Revista Clínica Española. 2015; 215 (4): 195-203. doi: 10.1016/j.rceng.2014.11.001.
  7. Deok M, Eun-Ho L, Hyun J, et al. Does remote ischaemic preconditioning with postconditioning improve clinical outcomes of patients undergoing cardiac surgery? Remote Ischaemic Preconditioning with Postconditioning Outcome Trial. Eur. Heart J. 2014; 35 (3): 176-83. doi: 10.1093/eurheartj/eht346.
  8. Dubey L. A rare case of stenting of spontaneous dissection of Shepherd's Crook right coronary artery. ARYA Atheroscler. 2014; 10 (2): 129-32. PMID: 25161681; PMCID: PMC4144368.
  9. Thompson CR, Buller CE, Sleeper LA, et al. Cardiogenic shock due to acute severe mitral regurgitation complicating acute myocardial infarction: a report from the SHOCK Trial Registry: Should we use emergently revascularize Occluded Coronaries in cardiogenic shock? J. Am. Coll. Cardiol. 2000; 36 (suppl A): 1104-9. doi: 10.1016/s0735-1097(00)00846-9.
  10. White HD, Barbash GI, Califf RM, et al. Age and outcome with contemporary thrombolytic therapy: results from the GUSTO-I trial: Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries Trial. Circulation. 1996; 94: 1826-33. doi: 10.1161/01.cir.94.8.1826.
  11. Kirkman M, Briscoe V, Clark N, et al. Diabetes in Older Adults. Diabetes Care. 2012; 35 (12): 2650-64. doi: 10.2337/dc12-1801.
  12. Chiariello M, Indolfi C. Silent Myocardial Ischemia in Patients with Diabetes Mellitus. Circulation. 1996; 93 (12): 2089-91. doi: 10.1161/01.CIR.93.12.2089.
  13. Toleva O, Ibrahim Q, Brass N, et al. Treatment choices in elderly patients with ST: elevation myocardial infarction—insights from the Vital Heart Response registry. Open Heart. 2015; 2 (1): e000235. DOI: 10.1136/ openhrt-2014-000235.
  14. Krumholz HM, Friesinger GC, Cook EF, et al. Relationship of age with eligibility for thrombolytic therapy and mortality among patients with suspected acute myocardial infarction. J. Am. Geriatr. Soc. 1994; 42: 127-31. doi: 10.1111/j.1532-5415.1994.tb04938.x.
  15. Krumholz HM, Gross CP, Peterson ED, et al. Is there evidence of implicit exclusion criteria for elderly subjects in randomized trials? Evidence from the GUSTO-1 Study. Am. Heart J. 2003; 146 (5): 839-47. doi: 10.1016/S0002-8703(03)00408-3.
  16. Antman EM, Anbe DT, Armstrong PW, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction: executive summary: a report of the ACC/AHA Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction). J. Am. Coll. Cardiol. 2004; 44 (3): 671–719. doi: 10.1161/01.CIR.0000134791.68010.FA.
  17. Anisimov V, Baranov V, Khavinson V. Programme “Prevention of Age-Related Pathology and Accelerated Aging, Reducing Premature Mortality and the Extension of the Working Life Span of the Population”: guidelines. Saint Petersburg: IPK KOSTA; 2008.
  18. Pfisterer M. Long-Term Outcome in Elderly Patients with Chronic Angina Managed Invasively Versus by Optimized Medical Therapy: Four-Year Follow-Up of the Randomized Trial of Invasive Versus Medical Therapy in Elderly Patients (TIME). Circulation. 2004; 110 (10): 1213-8. doi: 10.1161/01.CIR.0000140983.69571.BA.
  19. Rana O. Percutaneous coronary intervention in the very elderly (≥85 years): trends and outcomes. Br. J. Cardiol. 2013; 20: 27-31. doi: 10.5837/bjc.2013.006.
  20. De Luca L, Olivari Z, Bolognese L, et al. A decade of changes in clinical characteristics and management of elderly patients with non-ST elevation myocardial infarction admitted in Italian cardiac care units. Open Heart. 2014; 1 (1): 148. doi: 10.1136/openhrt-2014-000148.
  21. White H. Debate: Should the elderly receive thrombolytic therapy or primary angioplasty? Trials. 2000; 1: 150-4. doi: 10.1186/cvm-1-3-150.
  22. Thiemann DR, Coresh J, Schulman SP, et al. Lack of benefit for intravenous thrombolysis in patients with myocardial infarction who are older than 75 years. Circulation. 2000; 101 (19): 2239-46. doi: 10.1161/01.CIR.101.19.2239.
  23. Becker RC, Hochman JS, Cannon CP, et al. Fatal cardiac rupture among patients treated with thrombolytic agents and adjunctive thrombin antagonists: observations from the Thrombolysis and Thrombin Inhibition in Myocardial Infarction 9 Study. J. Am. Coll. Cardiol. 1999; 33 (2): 479-87. doi: 10.1016/s0735-1097(98)00582-8.
  24. Bueno H, Martínez-Sellés M, Pérez-David E, et al. Effect of thrombolytic therapy on the risk of cardiac rupture and mortality in older patients with first acute myocardial infarction. Eur. Heart J. 2005; 26 (17): 1705-11. doi: 10.1093/eurheartj/ehi284.
  25. ISIS-2. Randomised trial of intravenous streptokinase, oral aspirin, both of neither among 17187 cases of suspected acute myocardial infarction. Lancet. 1988; 2 (8607): 349-60. PMID: 2899772.
  26. Alexander K. Excess Dosing of Antiplatelet and Antithrombin Agents in the Treatment of Non-ST-Segment Elevation Acute Coronary Syndromes. JAMA. 2005; 294 (24): 3108. doi: 10.1001/jama.294.24.3108.
  27. Zhen-xian Y, Yu-jie Z, Ying-xin Z, et al. Safety and feasibility of transradial approach for primary percutaneous coronary intervention in elderly patients with acute myocardial infarction. Chinese medical journal. 2008; 121 (9): 782-6. doi: 10.1097/00029330-200805010-00004.
  28. Mehran R, Nikolsky E, Lansky A, et al. Impact of Chronic Kidney Disease on Early (30-Day) and Late (1-Year) Outcomes of Patients with Acute Coronary Syndromes Treated with Alternative Antithrombotic Treatment Strategies. JACC: Cardiovascular Interventions. 2009; 2 (8): 748-57. doi: 10.1016/j.jcin.2009.05. 018.
  29. Kozlov K, Semigolovskij N, Shnejder J. Angiography, angioplasty and stenting of the coronary arteries in the diagnosis and treatment of coronary heart disease. Guidelines. Saint-Petersburg: JeLBI-SPb; 2001.
  30. Kim J, Yang J, Choi S, et al. Predictors of Outcomes of Contrast-Induced Acute Kidney Injury After Percutaneous Coronary Intervention in Patients With Chronic Kidney Disease. The American Journal of Cardiology. 2014; 114 (12): 1830-5. doi: 10.1016/j.amjcard. 2014.09.022.
  31. Ageev FT, Belenkov YuN, Fomin IV, et al. Prevalence of chronic heart failure in the European part of the Russian Federation - data from EPOCH – CHF. Journal of Heart Failure. 2006; 7 (1): 112-5. doi: 10.18087/cardio.2475
  32. Khubulava GG, Kozlov KL, Bogomolov AN, et al. Auxiliary devices in the treatment of chronic heart failure in elderly and senile patients. Pharmacy Formulas. 2020; 2 (3): 40-57. doi: 10.17816/phf41944/2713-153X-2020-3-2-40-57.
  33. Pursnani S, Korley F, Gopaul R, et al. Percutaneous coronary intervention versus optimal medical therapy in stable coronary artery disease: a systematic review and meta-analysis of randomized clinical trials. Circ. Cardiovasc. Interv. 2012; 5 (4): 476-90. doi: 10.1161/CIRCINTERVENTIONS.112.970954.
  34. Dor V, Civaia F, Alexandrescu C, et al. Favorable effects of left ventricular reconstruction in patients excluded from the Surgical Treatments for Ischemic Heart Failure (STICH) trial. J. Thorac. Cardiovasc. Surg. 2011; 141 (4): 905-16. doi: 10.1016/j.jtcvs.2010.10.026.
  35. Kung H‐C, Hoyert DL, Xu J, et al. Deaths: final data for 2005. Natl Vital Stat Rep. 2008; 56 (10): 1-120. PMID: 18512336.
  36. Engberding N, Wenger NK. Acute Coronary Syndromes in the Elderly. F1000 Research. 2017; 6: 1791. doi: 10.12688/f1000research.11064.1.
  37. Alexander KP, Newby LK, Armstrong PW, et al. Acute coronary care in the elderly, part II: ST‐segment‐elevation myocardial infarction: a scientific statement for healthcare professionals from the American Heart Association Council on Clinical Cardiology: in collaboration with the Society of Geriatric Cardiology. Circulation. 2007; 115: 2570-89. doi: 10.1093/eurheartj/ehl067.
  38. Singh M, Peterson ED, Roe MT, et al. Trends in the association between age and in‐hospital mortality after percutaneous coronary intervention: National Cardiovascular Data Registry experience. Circ. Cardiovasc. Interv. 2009; 2: 20-6. doi: 10.1161/CIRCINTERVENTIONS.108.826172.
  39. Rajani R, Lindblom M, Dixon G, et al. Evolving trends in percutaneous coronary intervention. Br. J. Cardiol. 2011; 18: 73-6.
  40. Fox KA, Clayton TC, Damman P, et al. Long‐term outcome of a routine versus selective invasive strategy in patients with non‐ST‐segment elevation acute coronary syndrome a meta‐analysis of individual patient data. J. Am. Coll. Cardiol. 2010; 55: 2435-45. doi: 10.1016/j.jacc. 2010.03.007.
  41. Kumar S, McDaniel M, Samady H, et al. Contemporary Revascularization Dilemmas in Older Adults. Journal of the American Heart Association. 2020; 9 (3): e014477. doi: 10.1161/JAHA.119.014477.
  42. Roger VL, Jacobsen SJ, Weston SA, et al. Trends in heart disease deaths in Olmsted County, Minnesota, 1979–1994. Mayo Clin Proc. 1999; 74 (7): 651-7. doi: 10.4065/74.7.651.

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