Evidence map›Paper›PMID 34873049›Full record

Observational studyOpen heart2021

Activation of PPCI team in the octogenarian and nonagenarians population: real-world single-centre experience.

Rajesh Kumar, Cormac O'Connor, Jathinder Kumar, Brain Kerr, Ihtisham Malik, Ciarrai Homer, Syed Abbas, Samer Arnous, Ihsan Ullah, Thomas John Kiernan

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in Open heart, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 44% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Rajesh KumarDepartment of Cardiology, University Hospital Limerick, Dooradoyle, Ireland rajesh2k7@yahoo.com.ORCID 0000-0002-8002-1551
Cormac O'ConnorDepartment of Cardiology, University Hospital Limerick, Dooradoyle, Ireland.
Jathinder KumarDepartment of Cardiology, University Hospital Limerick, Dooradoyle, Ireland.
Brain KerrDepartment of Cardiology, University Hospital Limerick, Dooradoyle, Ireland.ORCID 0000-0002-4071-8960
Ihtisham MalikDepartment of Cardiology, University Hospital Limerick, Dooradoyle, Ireland.
Ciarrai HomerDepartment of Cardiology, University Hospital Limerick, Dooradoyle, Ireland.
Syed AbbasDepartment of Cardiology, University Hospital Limerick, Dooradoyle, Ireland.
Samer ArnousDepartment of Cardiology, University Hospital Limerick, Dooradoyle, Ireland.
Ihsan UllahDepartment of Cardiology, University Hospital Limerick, Dooradoyle, Ireland.
Thomas John KiernanDepartment of Cardiology, University Hospital Limerick, Dooradoyle, Ireland.
University Hospital Limerick · IE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveAdvancement in healthcare provision has led to increasing octogenarian ST elevation myocardial infarction (STEMI) presentation to hospital for early revascularisation therapies. Limited literature to date exists to suggest octogenarian STEMI population; with majority of trials excluding these age group patients. Due to an ageing population, we expect increasing rates of STEMI in the octogenarian and nonagenarian population in the future. This study seeks to identify the outcomes of patients over the age of 80 presenting with STEMI and determine the factors associated with better or worse outcome. PATIENTS AND

methodsThis study is a single-centre retrospective observational study involving patients' age 80 or older presenting with STEMI between January 2014 and December 2019. Patient data were collected by chart review and analysis of the local STEMI database. Standard Bayesian statistics were employed for analysis.

results1301 patients presented with STEMI during this period. 159/1301 (12.2%) were 80 years or older that fulfilled STEMI criteria, 35/159 (22.1%) were medically managed. 107/124 (86.29%) had angiographic evidence of acute total or partial thrombotic occlusion, and 97/107 were treated with primary percutaneous coronary intervention (PPCI). The activation ECG most commonly exhibited an anterior STEMI, while inferior STEMI ECGs had the strongest positive predictive value. PPCI group had a 30-day mortality rate of 20% (p=0.07) and 1-year mortality was 22.4%. Highest mortality was observed with cardiogenic shock, low ejection fraction, higher high sensitivity cardiac troponin T and creatinine at presentation. Conservatively managed patients had significant higher mortality rate (48% vs 22.4%, p=0.005) at 1 year.

conclusionPatients over the age of 80 who present with STEMI and undergo PPCI have a significantly lower mortality rate at 1 year. These patients have a 77.6% survival at 1 year, with 92.4% likelihood of discharge to home (without need for long-term nursing home care). Cardiogenic shock in this group was associated with a 1-year mortality of 87.5%. Despite the advanced age, we suggest favourable outcomes described in the absence of patients presenting with cardiogenic shock.

Indexed as

ElectrocardiographyAged, 80 and overBayes TheoremFemaleFollow-Up StudiesHospital MortalityHumansIncidenceIrelandMaleNonagenariansPercutaneous Coronary InterventionPredictive Value of TestsRetrospective StudiesRisk FactorsST Elevation Myocardial Infarctiondelivery of health carepercutaneous coronary interventionSTEMI

Identifiers

PMID34873049
PMCPMC8650482
OpenAlexW4200593498

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.