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Secondary cardiovascular prevention in older adults： an evidence based review

Journal of Geriatric Cardiology 2015年第5期12卷 459-464页

作者： abdulla a damluji Archana Ramlreddy Lynda Otalvaro Daniel E Forman Cardiovascular Division and Elaine and Sydney Sussman Cardiac Catheterization Laboratory University of Miami Miller School of Medicine MiamL FL USA Geriatric Cardiology Section University of Pittsburgh Medical Center Pittsburgh PA USA

1 BackgroundIn the United States, life expectancy is rising, particularly among the older population （〉 65 years）, with projected estimates approaching 20% by year 2050. Despite improved survival estimates, cardiovascular diseases remain the leading cause of morbidity and mortality resulting in substantial increase in health care cost. For younger adults, the evidence for secondary cardiovascular prevention is well established and corroborated by robust data. However, the application of risk reduction strategies in older populations remains an area of active debate. Many assume that vulnerability to chronic cardiovascular diseases is an inexorable part of aging such that the risks attributable to prevention outweigh potential benefits.

关键词： Cardiovascular disease Cardiovascular prevention Dyslipidemia Diabetes mellitus The elderly

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In-hospital outcomes and readmission in older adults treated with percutaneous coronary intervention for stable ischemic heart disease

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Journal of Geriatric Cardiology 2022年第9期19卷 631-642页

作者： Dae Yong Park Jonathan M.Hanna Sumeet Kadian Mannat Kadian WSchuyler Jones abdulla Al damluji Ajar Kochar Jeptha P.Curtis Michael G.Nanna Department of Medicine Cook County HealthChicagoILUSA Department of Internal Medicine Yale School of MedicineNew HavenCTUSA University of Connecticut StorrsCTUSA East Lyme High School East LymeCTUSA Section of Interventional Cardiology Duke University Health SystemDurhamNCUSA Section of Interventional Cardiology Johns Hopkins UniversityBaltimoreMDUSA Section of Interventional Cardiology Brigham and Women’s HospitalBostonMAUSA Section of Cardiovascular Medicine Yale School of MedicineNew HavenCTUSA

Background Percutaneous coronary intervention(PCI)for stable ischemic heart disease(SIHD)in older adults requires a metic-ulous assessment of procedural risks and benefits,but contemporary data on outcomes in this population is ***,we examined the risk of near-term readmission,bleeding,and mortality in high-risk cohort of older adults undergoing inpatient PCI for *** We analyzed the National Readmissions Database from 2017 to 2018 to identify index hospitalizations in which PCI was performed for *** were stratified into those≥75 years old(older adults)and those<75 years *** primary outcome was 90-day *** outcomes included in-hospital mortality,hospital length of stay(LOS),and total hospital *** A total of 74,516 patients underwent inpatient PCI for SIHD,of whom 24,075 were older *** adult patients had higher odds of in-hospital mortality(OR=2.00,95%CI:1.68-2.38),intracranial hemorrhage(OR=2.03,95%CI:1.24-3.34),and gastrointestinal hemorrhage(OR=1.72,95%CI:1.43-2.07)during index hospitalization,with longer LOS and in-hospital *** adults also experienced a higher hazard of 90-day readmission for any cause(HR=1.61,95%CI:1.57-1.66)and car-diovascular causes(HR=1.84,95%CI:1.77-1.91).CONCLUSION Older adults undergoing inpatient PCI for SIHD were at increased risk for in-hospital mortality,periprocedural morbidities,higher cost,and readmissions compared with younger *** these differences may improve shared decision-making for patients with SIHD being considered for PCI.

关键词： mortality coronary younger

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