TY - JOUR
T1 - Treatment of elderly patients with non-ST-elevation myocardial infarction
T2 - the nationwide POPular age registry
AU - Gimbel, Marieke E.
AU - Yin, Dean R. P. P. Chan Pin
AU - van den Broek, Wout W. A.
AU - Hermanides, Renicus S.
AU - Kauer, Floris
AU - Tavenier, Annerieke H.
AU - Schellings, Dirk
AU - Brinckman, Stijn L.
AU - The, Salem H. K.
AU - Stoel, Martin G.
AU - Heestermans, Ton A. C. M.
AU - Rasoul, Saman
AU - Emans, Mireille E.
AU - van de Wetering, Machiel
AU - van Bergen, Paul F. M. M.
AU - Walhout, Ronald
AU - Nicastia, Debby
AU - Aksoy, Ismail
AU - van 't Hof, Arnoud
AU - Knaapen, Paul
AU - Botman, Cees-Joost
AU - Liem, Anho
AU - de Nooijer, Cornelis
AU - Peper, Joyce
AU - Kelder, Johannes C.
AU - ten Berg, Jurrien M.
PY - 2024/2
Y1 - 2024/2
N2 - ObjectiveWe describe the current treatment of elderly patients with non-ST-elevation myocardial infarction (NSTEMI) enrolled in a national registry.MethodsThe 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.ResultsA 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.ConclusionsIn 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.
AB - ObjectiveWe describe the current treatment of elderly patients with non-ST-elevation myocardial infarction (NSTEMI) enrolled in a national registry.MethodsThe 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.ResultsA 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.ConclusionsIn 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.
KW - Antiplatelet therapy
KW - Non-ST-elevation myocardial infarction
KW - Elderly
KW - Therapy
KW - DUAL ANTIPLATELET THERAPY
KW - ACUTE CORONARY SYNDROMES
KW - OPEN-LABEL
KW - CLOPIDOGREL
KW - OUTCOMES
KW - TICAGRELOR
KW - PRASUGREL
KW - OLDER
KW - VALIDATION
KW - STRATEGY
U2 - 10.1007/s12471-023-01812-0
DO - 10.1007/s12471-023-01812-0
M3 - Article
SN - 1568-5888
VL - 32
SP - 84
EP - 90
JO - Netherlands Heart Journal
JF - Netherlands Heart Journal
IS - 2
ER -