Impact of Frailty and Functional Status on Outcomes in Elderly Patients With ST‐Segment Elevation Myocardial Infarction Undergoing Primary Angioplasty: Rationale and Design of the IFFANIAM Study

Abstract The IFFANIAM study (Impact of frailty and functional status in elderly patients with ST segment elevation myocardial infarction undergoing primary angioplasty) is an observational multicenter registry to assess the impact of frailty and functional status on outcomes of elderly patients with ST‐segment elevation myocardial infarction (STEMI) undergoing primary angioplasty. STEMI patients age 75 years or older undergoing primary angioplasty will be extensively studied during admission in 4 tertiary care Hospitals in Spain, assessing their baseline functional status (Barthel index, Lawton‐Brody index), frailty (Fried criteria, FRAIL scale [fatigue, resistance, ambulation, illnesses, and loss of weight]), comorbidities (Charlson index), nutritional status (Mini Nutritional Assessment–Short Form), and quality of life (Seattle Angina Questionnaire). Participants will be managed according current recommendations. The primary outcome will be the description of 1‐year mortality, its causes, and associated factors. Secondary outcomes will be functional capacity and quality of life. Results will help to better understand the impact of frailty and functional ability on outcomes in elderly STEMI patients undergoing primary angioplasty, thus potentially contributing to improving their clinical management. Higher life expectancy has resulted in a large segment of elderly population and an increase in myocardial infarction in these patients. This calls attention to healt...
Source: Clinical Cardiology - Category: Cardiology Authors: Tags: Trial Design Source Type: research

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AbstractThe Medina classification is the most widespread method to describe bifurcation lesions. However, little is known regarding its prognostic impact. Therefore, the aim of this study is to assess the prognostic significance of the Medina classification following percutaneous coronary intervention (PCI). From a prospective registry of 738 consecutive patients undergoing PCI for bifurcation lesions, 505 were treated with second-generation drug-eluting stents (DES). Of these, 407 (80.6%) presented with “true bifurcation” (TB) lesions (Medina class 1.0.1, 1.1.1, 0.1.1) and 98 (19.4%) in all other categories (&...
Source: Heart and Vessels - Category: Cardiology Source Type: research
Conclusions: This retrospective study suggests that PCI performed in cocaine-associated myocardial infarction comes with a high 30-day and one-year risk. Further prospective studies are needed to better define this risk and to lend insight into better management strategies. PMID: 32051707 [PubMed]
Source: Archives of Medical Science - Category: General Medicine Tags: Arch Med Sci Source Type: research
AbstractMicrovascular obstruction following percutaneous coronary intervention (PCI) is highly prevalent and independently associated with adverse clinical outcomes. Microvascular obstruction is determined by index of the microvascular resistance. We performed a systematic review with meta-analysis of all published randomized clinical trials (RCTs) studying the effect of intra-coronary thrombolysis with PCI as compared to standard treatment among patients with ST-segment elevated myocardial infarction. We included 6 RCTs summing up to 947 patients in the final analysis. Intra-coronary thrombolysis resulted in significantly...
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research
AbstractAimTo evaluate the impact of left ventricular ejection fraction (LVEF) on 3 ‐year outcomes in patients with left main coronary artery disease (LMCAD) undergoing percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) in the EXCEL trial.Methods and resultsThe EXCEL trial randomized patients with LMCAD to PCI with everolimus ‐eluting stents (n = 948) or CABG (n = 957). Among 1804 patients with known baseline LVEF, 74 (4.1%) had LVEF
Source: European Journal of Heart Failure - Category: Cardiology Authors: Tags: Research Article Source Type: research
CONCLUSIONS: The use of Agent DCBs during PCI appears safe and effective in a large real-world registry. These results were maintained in all subgroups, with a slightly higher trend of events rates in the ISR setting, consistent with the higher-risk nature of this patient subset. PMID: 32045346 [PubMed - as supplied by publisher]
Source: The Journal of Invasive Cardiology - Category: Cardiology Tags: J Invasive Cardiol Source Type: research
Publication date: Available online 11 February 2020Source: The Annals of Thoracic SurgeryAuthor(s): Jared P. Beller, William Z. Chancellor, J. Hunter Mehaffey, Robert B. Hawkins, Matthew R. Byler, Alan M. Speir, Mohammed A. Quader, Andy C. Kiser, Leora T. Yarboro, Gorav Ailawadi, Nicholas R. TemanAbstractBackgroundContinuation of dual antiplatelet therapy (DAPT) following coronary artery bypass grafting (CABG) after acute myocardial infarction is recommended by current guidelines. We sought to evaluate guideline adherence over time and factors associated with post-operative DAPT within a regional consortium.MethodsIsolated...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
AbstractCoronary artery disease remains the major cause of mortality worldwide. Antiplatelet drugs such as acetylsalicylic acid and P2Y12 receptor antagonists are cornerstone treatments for the prevention of thrombotic events in patients with coronary artery disease. Clopidogrel has long been the gold standard but has major pharmacological limitations such as a slow onset and long duration of effect, as well as weak platelet inhibition with high inter-individual pharmacokinetic and pharmacodynamic variability. There has been a strong need to develop potent P2Y12 receptor antagonists with more favorable pharmacological prop...
Source: Clinical Pharmacokinetics - Category: Drugs & Pharmacology Source Type: research
AbstractAlthough there is accumulating evidence for the usefulness of imaging-guided percutaneous coronary intervention (PCI), there are few studies for acute coronary syndrome (ACS), and the impact of the frequency of use has not been well addressed. From the Kumamoto Intervention Conference Study; a Japanese registry comprising 17 institutions, consecutive patients undergoing successful PCI from April 2008 through March 2014 were enrolled. Subjects were divided into two groups: imaging-guided PCI and angiography-guided PCI. Clinical outcome was a composite of cardiac death, non-fatal myocardial infarction, and stent thro...
Source: Cardiovascular Intervention and Therapeutics - Category: Cardiology Source Type: research
AbstractAimTo evaluate the impact of left ventricular ejection fraction (LVEF) on 3 ‐year outcomes in patients with left main coronary artery disease (LMCAD) undergoing percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) in the EXCEL trial.Methods and resultsThe EXCEL trial randomized patients with LMCAD to PCI with everolimus ‐eluting stents (n = 948) or CABG (n = 957). Among 1804 patients with known baseline LVEF, 74 (4.1%) had LVEF
Source: European Journal of Heart Failure - Category: Cardiology Authors: Tags: Research Article Source Type: research
Cardiogenic shock (CS) is the most serious complication of acute myocardial infarction (AMI). The practice of early revascularization by percutaneous coronary intervention, and advances in pharmacotherapy have reduced the rate of complications of CS. However, when CS is combined with AMI, mortality from AMI is still high, and many clinicians are wondering how to treat CS with AMI. In recent years, mechanical circulatory support (MCS) devices have improved the clinical outcome in AMI patients with CS. For best outcome, treatment of AMI with CS should always consider treatments that improve the prognosis of the patients.
Source: Heart Failure Clinics - Category: Cardiology Authors: Source Type: research
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