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Article
Changing Trends in, and Characteristics Associated with, Not Undergoing Cardiac Catheterization in Elderly Adults Hospitalized with ST-Segment Elevation Acute Myocardial Infarction
University of Massachusetts Medical School Faculty Publications
  • Mayra Tisminetzky, University of Massachusetts Medical School
  • Nathaniel A. Erskine, University of Massachusetts Medical School
  • Han-Yang Chen, University of Massachusetts Medical School
  • Joel M. Gore, University of Massachusetts Medical School
  • Jerry H. Gurwitz, University of Massachusetts Medical School
  • Jorge L. Yarzebski, University of Massachusetts Medical School
  • Samuel W. Joffe, University of Massachusetts Medical School
  • Peter Shaw, University of Massachusetts Medical School
  • Robert J. Goldberg, University of Massachusetts Medical School
UMMS Affiliation
Department of Quantitative Health Sciences; Department of Medicine, Division of Cardiovascular Medicine; Meyers Primary Care Institute; Department of Medicine, Division of Geriatric Medicine
Date
5-1-2015
Document Type
Article
Abstract
OBJECTIVES: To describe decade- long trends (1999-2009) in the rates of not undergoing cardiac catheterization and percutaneous coronary intervention (PCI) in individuals aged 65 and older presenting with an ST-segment elevation acute myocardial infarction (STEMI) and factors associated with not undergoing these procedures. DESIGN: Observational population-based study. SETTING: Worcester, Massachusetts, metropolitan area. PARTICIPANTS: Individuals aged 65 and older hospitalized for an STEMI in six biennial periods between 1999 and 2009 at 11 central Massachusetts medical centers (N=960). MEASUREMENTS: Analyses were conducted to examine the characteristics of people who did not undergo cardiac catheterization overall and stratified into two age strata (65-74, > /=75). RESULTS: Between 1999 and 2009, dramatic declines (from 59.4% to 7.5%) were observed in the proportion of older adults who did not undergo cardiac catheterization at all greater Worcester hospitals. These declines were observed in individuals aged 65 to 74 (58.4-6.7%) and in those aged 75 and older (69.4-13.5%). The proportion of individuals not undergoing PCI after undergoing cardiac catheterization decreased from 36.6% in 1999 to 6.5% in 2009. Women, individuals with a prior MI, those with do-not-resuscitate orders, and those with various comorbidities were less likely to have undergone these procedures than comparison groups. CONCLUSION: Older adults who develop an STEMI are increasingly likely to undergo cardiac catheterization and PCI, but several high-risk groups remain less likely to undergo these procedures.
Rights and Permissions
Citation: J Am Geriatr Soc. 2015 May;63(5):925-31. doi: 10.1111/jgs.13399. Epub 2015 May 4. Link to article on publisher's site
Related Resources
Link to Article in PubMed
Keywords
  • ST-segment elevation acute myocardial infarction,
  • cardiac catheterization,
  • elderly adults
PubMed ID
25940950
Citation Information
Mayra Tisminetzky, Nathaniel A. Erskine, Han-Yang Chen, Joel M. Gore, et al.. "Changing Trends in, and Characteristics Associated with, Not Undergoing Cardiac Catheterization in Elderly Adults Hospitalized with ST-Segment Elevation Acute Myocardial Infarction" Vol. 63 Iss. 5 (2015) ISSN: 0002-8614 (Linking)
Available at: http://works.bepress.com/jorge_yarzebski/105/