Marieke E Gimbel, Dean R P P Chan Pin Yin, Wout W A van den Broek, Renicus S Hermanides, Floris Kauer, Annerieke H Tavenier, Dirk Schellings, Stijn L Brinckman, Salem H K The, Martin G Stoel, Ton A C M Heestermans, Saman Rasoul, Mireille E Emans, Machiel van de Wetering, Paul F M M van Bergen, Ronald Walhout, Debby Nicastia, Ismail Aksoy, Arnoud van 't Hof, Paul Knaapen, Cees-Joost Botman, Anho Liem, Cornelis de Nooijer, Joyce Peper, Johannes C Kelder, Jurriën M Ten Berg
{"title":"老年非ST段抬高型心肌梗死患者的治疗：全国POPular年龄登记。","authors":"Marieke E Gimbel, Dean R P P Chan Pin Yin, Wout W A van den Broek, Renicus S Hermanides, Floris Kauer, Annerieke H Tavenier, Dirk Schellings, Stijn L Brinckman, Salem H K The, Martin G Stoel, Ton A C M Heestermans, Saman Rasoul, Mireille E Emans, Machiel van de Wetering, Paul F M M van Bergen, Ronald Walhout, Debby Nicastia, Ismail Aksoy, Arnoud van 't Hof, Paul Knaapen, Cees-Joost Botman, Anho Liem, Cornelis de Nooijer, Joyce Peper, Johannes C Kelder, Jurriën M Ten Berg","doi":"10.1007/s12471-023-01812-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>We describe the current treatment of elderly patients with non-ST-elevation myocardial infarction (NSTEMI) enrolled in a national registry.</p><p><strong>Methods: </strong>The POPular AGE registry is a prospective, multicentre study of patients ≥ 75 years of age presenting with NSTEMI, performed in the Netherlands. Management was at the discretion of the treating physician. Cardiovascular events consisted of cardiovascular death, myocardial infarction and ischaemic stroke. Bleeding was classified according to the Bleeding Academic Research Consortium (BARC) criteria.</p><p><strong>Results: </strong>A total of 646 patients were enrolled between August 2016 and May 2018. Median age was 81 (IQR 77-84) years and 58% were male. Overall, 75% underwent coronary angiography, 40% percutaneous coronary intervention, and 11% coronary artery bypass grafting, while 49.8% received pharmacological therapy only. At discharge, dual antiplatelet therapy (aspirin and P2Y<sub>12</sub> inhibitor) was prescribed to 56.7%, and 27.4% received oral anticoagulation plus at least one antiplatelet agent. At 1‑year follow-up, cardiovascular death, myocardial infarction or stroke had occurred in 13.6% and major bleeding (BARC 3 and 5) in 3.9% of patients. The risk of both cardiovascular events and major bleeding was highest during the 1st month. However, cardiovascular risk was three times as high as bleeding risk in this elderly population, both after 1 month and after 1 year.</p><p><strong>Conclusions: </strong>In this national registry of elderly patients with NSTEMI, the majority are treated according to current European Society of Cardiology guidelines. Both the cardiovascular and bleeding risk are highest during the 1st month after NSTEMI. However, the cardiovascular risk was three times as high as the bleeding risk.</p>","PeriodicalId":18952,"journal":{"name":"Netherlands Heart Journal","volume":" ","pages":"84-90"},"PeriodicalIF":1.7000,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10834918/pdf/","citationCount":"0","resultStr":"{\"title\":\"Treatment of elderly patients with non-ST-elevation myocardial infarction: the nationwide POPular age registry.\",\"authors\":\"Marieke E Gimbel, Dean R P P Chan Pin Yin, Wout W A van den Broek, Renicus S Hermanides, Floris Kauer, Annerieke H Tavenier, Dirk Schellings, Stijn L Brinckman, Salem H K The, Martin G Stoel, Ton A C M Heestermans, Saman Rasoul, Mireille E Emans, Machiel van de Wetering, Paul F M M van Bergen, Ronald Walhout, Debby Nicastia, Ismail Aksoy, Arnoud van 't Hof, Paul Knaapen, Cees-Joost Botman, Anho Liem, Cornelis de Nooijer, Joyce Peper, Johannes C Kelder, Jurriën M Ten Berg\",\"doi\":\"10.1007/s12471-023-01812-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>We describe the current treatment of elderly patients with non-ST-elevation myocardial infarction (NSTEMI) enrolled in a national registry.</p><p><strong>Methods: </strong>The POPular AGE registry is a prospective, multicentre study of patients ≥ 75 years of age presenting with NSTEMI, performed in the Netherlands. Management was at the discretion of the treating physician. Cardiovascular events consisted of cardiovascular death, myocardial infarction and ischaemic stroke. Bleeding was classified according to the Bleeding Academic Research Consortium (BARC) criteria.</p><p><strong>Results: </strong>A total of 646 patients were enrolled between August 2016 and May 2018. Median age was 81 (IQR 77-84) years and 58% were male. Overall, 75% underwent coronary angiography, 40% percutaneous coronary intervention, and 11% coronary artery bypass grafting, while 49.8% received pharmacological therapy only. At discharge, dual antiplatelet therapy (aspirin and P2Y<sub>12</sub> inhibitor) was prescribed to 56.7%, and 27.4% received oral anticoagulation plus at least one antiplatelet agent. At 1‑year follow-up, cardiovascular death, myocardial infarction or stroke had occurred in 13.6% and major bleeding (BARC 3 and 5) in 3.9% of patients. The risk of both cardiovascular events and major bleeding was highest during the 1st month. However, cardiovascular risk was three times as high as bleeding risk in this elderly population, both after 1 month and after 1 year.</p><p><strong>Conclusions: </strong>In this national registry of elderly patients with NSTEMI, the majority are treated according to current European Society of Cardiology guidelines. Both the cardiovascular and bleeding risk are highest during the 1st month after NSTEMI. However, the cardiovascular risk was three times as high as the bleeding risk.</p>\",\"PeriodicalId\":18952,\"journal\":{\"name\":\"Netherlands Heart Journal\",\"volume\":\" \",\"pages\":\"84-90\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2024-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10834918/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Netherlands Heart Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s12471-023-01812-0\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/9/28 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Netherlands Heart Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12471-023-01812-0","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/9/28 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Treatment of elderly patients with non-ST-elevation myocardial infarction: the nationwide POPular age registry.
Objective: We describe the current treatment of elderly patients with non-ST-elevation myocardial infarction (NSTEMI) enrolled in a national registry.
Methods: The POPular AGE registry is a prospective, multicentre study of patients ≥ 75 years of age presenting with NSTEMI, performed in the Netherlands. Management was at the discretion of the treating physician. Cardiovascular events consisted of cardiovascular death, myocardial infarction and ischaemic stroke. Bleeding was classified according to the Bleeding Academic Research Consortium (BARC) criteria.
Results: A total of 646 patients were enrolled between August 2016 and May 2018. Median age was 81 (IQR 77-84) years and 58% were male. Overall, 75% underwent coronary angiography, 40% percutaneous coronary intervention, and 11% coronary artery bypass grafting, while 49.8% received pharmacological therapy only. At discharge, dual antiplatelet therapy (aspirin and P2Y12 inhibitor) was prescribed to 56.7%, and 27.4% received oral anticoagulation plus at least one antiplatelet agent. At 1‑year follow-up, cardiovascular death, myocardial infarction or stroke had occurred in 13.6% and major bleeding (BARC 3 and 5) in 3.9% of patients. The risk of both cardiovascular events and major bleeding was highest during the 1st month. However, cardiovascular risk was three times as high as bleeding risk in this elderly population, both after 1 month and after 1 year.
Conclusions: In this national registry of elderly patients with NSTEMI, the majority are treated according to current European Society of Cardiology guidelines. Both the cardiovascular and bleeding risk are highest during the 1st month after NSTEMI. However, the cardiovascular risk was three times as high as the bleeding risk.
期刊介绍：
The scope of the Netherlands Heart Journal is to contribute to the national and international literature by publishing scientific papers in the field of cardiovascular medicine. It also provides a platform for Continuing Medical Education for cardiologists and those in training for the speciality of cardiology in the Netherlands.
The Netherlands Heart Journal is made available to cardiologists, cardiologists in training, cardiopulmonary surgeons, cardiopulmonary surgeons in training, internists and paediatric cardiologists. The journal is the official journal of the Netherlands Society of Cardiology.
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