Особенности ведения пожилых пациентов с инфарктом миокарда без подъема сегмента ST: анализ факторов риска, диагностика и тактика лечения

Особенности ведения пожилых пациентов с инфарктом миокарда без подъема сегмента ST: анализ факторов риска, диагностика и тактика лечения

Автор: Зайнобидинов Ш. Ш., Хелимский Д. А., Баранов А. А., Горгулько А. П., Манукян С. Н., Найденов Р. А., Крестьянинов О. В.

Журнал: Сибирский журнал клинической и экспериментальной медицины @cardiotomsk

Рубрика: Клинические исследования

Статья в выпуске: 2 т.38, 2023 года.

Бесплатный доступ

Несмотря на развитие современных технологий в сфере здравоохранения, летальность от сердечно-сосудистых заболеваний занимает лидирующее место в структуре общей смертности населения. Применение современных методов лечения, особенно чрескожного коронарного вмешательства (ЧКВ), позволяет оказывать своевременную помощь пациентам с острым коронарным синдромом (ОКС) и способствует снижению частоты летальных событий. В настоящее время разработаны четкие алгоритмы ведения пациентов с инфарктом миокарда с подъемом сегмента ST (ИМпST), однако, несмотря на это, существуют парадигмы при ведении пациентов с инфарктом миокарда без подъема сегмента ST (ИМбпST). В первую очередь это связано с тем, что подавляюще большинство пациентов с ИМбпST представлены лицами пожилого и старческого возраста. В настоящей обзорной статье авторы описали основные факторы, которые негативно влияют на краткосрочный и долгосрочный прогноз и продемонстрировали результаты клинических исследований, посвященных к изучению данной проблемы.

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Острый коронарный синдром, инфаркт миокарда, инфаркт миокарда без подъема сегмента st, чрескожное коронарное вмешательство

Короткий адрес: https://sciup.org/149142854

IDR: 149142854   |   DOI: 10.29001/2073-8552-2023-38-2-98-103

Список литературы Особенности ведения пожилых пациентов с инфарктом миокарда без подъема сегмента ST: анализ факторов риска, диагностика и тактика лечения

  • Федеральная служба государственной статистики (Росстат) 2020 г. [Federal State Statistics Service (Rosstat) 2020. (In Russ.)]. URL: https://rosstat.gov.ru/folder/12781 (21.12.2022).
  • Basit H., Malik A., Huecker M.R. Non ST Segment Elevation Myocardial Infarction; 2022. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022.
  • Khera S., Kolte D., Aronow W.S., Palaniswamy C., Subramanian K.S., Hashim T. et al. Non-ST-elevation myocardial infarction in the United States: contemporary trends in incidence, utilization of the early invasive strategy, and in-hospital outcomes. J. Am. Heart Assoc. 2014;3(4):e000995. https://doi.org/10.1161/JAHA.114.000995.
  • Yeh R.W., Sidney S., Chandra M., Sorel M., Selby J.V., Go A.S. Population trends in the incidence and outcomes of acute myocardial infarction. N. Engl. J. Med. 2010;362(23):2155-2165. https://doi.org/10.1056/NEJMoa0908610.
  • Dyussenbayev A. Age periods of human life. Advances in Social Sciences Research Journal. 2017;4(6). https://doi.org/10.14738/assrj.46.2924. 6. Nichols M., Townsend N., Scarborough P., Rayner M. Cardiovascular disease in Europe 2014: epidemiological update. Eur. Heart J. 2014;35(42):2950-2959. https://doi.org/10.1093/eurheartj/ehu299.
  • Rogers W.J., Canto J.G., Lambrew C.T., Tiefenbrunn A.J., Kinkaid B., Shoultz D.A. et al. Temporal trends in the treatment of over 1.5 million patients with myocardial infarction in the US from 1990 through 1999: the National Registry of Myocardial Infarction 1, 2 and 3. J. Am. Coll. Cardiol. 2000;36(7):2056-63. https://doi.org/10.1016/s0735-1097(00)00996-7.
  • Carro A., Kaski J.C. Myocardial infarction in the elderly. Aging Dis. 2011;2(2):116-137.
  • Rashid M., Fischman D.L., Gulati M., Tamman K., Potts J., Kwok C.Sh. et al. Temporal trends and inequalities in coronary angiography utilization in the management of non-ST-Elevation acute coronary syndromes in the U.S. Sci. Rep. 2019;9:240. https://doi.org/10.1038/s41598-018-36504-y.
  • Morici N., Savonitto S., Ferri L.A., Grosseto D., Bossi I., Sganzerla P. et al. Elderly ACS-2 Investigators. Outcomes of Elderly Patients with ST-Elevation or Non-ST-Elevation Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention. Am. J. Med. 2019;132(2):209-216. https://doi.org/10.1016/j.amjmed.2018.10.027.
  • Kaura A., Sterne J.A.C., Trickey A., Abbott S., Mulla A., Glampson B. et al. Invasive versus non-invasive management of older patients with nonST elevation myocardial infarction (SENIOR-NSTEMI): a cohort study based on routine clinical data. Lancet. 2020;396(10251):623-634. https://doi.org/10.1016/S0140-6736(20)30930-2.
  • Al Suwaidi J., Reddan D.N., Williams K., Pieper K.S., Harrington R.A., Califf R.M. et al. Prognostic implications of abnormalities in renal function in patients with acute coronary syndromes. Circulation. 2002;106(8):974-80. https://doi.org/10.1161/01.cir.0000027560.41358.b3.
  • Ekerstad N., Swahn E., Janzon M., Alfredsson J., Löfmark R., Lindenberger M. et al. Frailty is independently associated with short-term outcomes for elderly patients with non-ST-segment elevation myocardial infarction. Circulation. 2011;124(22):2397-2404. https://doi.org/10.1161/CIRCULATIONAHA.111.025452.
  • Afilalo J., Alexander K.P., Mack M.J., Maurer M.S., Green P., Allen L.A. et al. Frailty assessment in the cardiovascular care of older adults. J. Am. Coll. Cardiol. 2014;63(8):747-762. https://doi.org/10.1016/j.jacc.2013.09.070.
  • Fried L.P., Tangen C.M., Walston J., Newman A.B., Hirsch C., Gottdiener J. et al. Frailty in older adults: evidence for a phenotype. J. Gerontol. A. Biol. Sci. Med. Sci. 2001;56(3):M146-56. https://doi.org/10.1093/gerona/56.3.m146.
  • Sanchis J., Bonanad C., Ruiz V., Fernández J., García-Blas S., Mainar L. et al. Frailty and other geriatric conditions for risk stratification of older patients with acute coronary syndrome. Am. Heart J. 2014;168(5):784-791. https://doi.org/10.1016/j.ahj.2014.07.022.
  • Ekerstad N., Swahn E., Janzon M., Alfredsson J., Löfmark R., Lindenberger M. et al. Frailty is independently associated with 1-year mortality for elderly patients with non-ST-segment elevation myocardial infarction. Eur. J. Prev. Cardiol. 2014;21(10):1216-1224. https://doi.org/10.1177/2047487313490257.
  • Sanchis J., Soler M., Núñez J., Ruiz V., Bonanad C., Formiga F. et al. Comorbidity assessment for mortality risk stratification in elderly patients with acute coronary syndrome. Eur. J. Intern. Med. 2019;62:48-53. https://doi.org/10.1016/j.ejim.2019.01.018.
  • Sabatine M.S., Morrow D.A., Giugliano R.P., Burton P.B., Murphy S.A., McCabe C.H. et al. Association of hemoglobin levels with clinical outcomes in acute coronary syndromes. Circulation. 2005;111(16):2042-2049. https://doi.org/10.1161/01.CIR.0000162477.70955.5F.
  • Lawler P.R., Filion K.B., Dourian T., Atallah R., Garfinkle M., Eisenberg M.J. Anemia and mortality in acute coronary syndromes: a systematic review and meta-analysis. Am. Heart J. 2013;165(2):143-53.e5. https://doi.org/10.1016/j.ahj.2012.10.024.
  • Gaskell H., Derry S., Moore A.R., McQuay H.J. Prevalence of anaemia in older persons: systematic review. BMC Geriatr. 2008;8:1. https://doi.org/10.1186/1471-2318-8-1.
  • Dodson J.A., Hajduk A.M., Murphy T.E., Geda M., Krumholz H.M., Tsang S. et al. 180-day readmission risk model for older adults with acute myocardial infarction: the SILVER-AMI study. Open Heart. 2021;8(1):e001442. https://doi.org/10.1136/openhrt-2020-001442.
  • Avezum A., Makdisse M., Spencer F., Gore J.M., Fox K.A., Montalescot G. et al. Impact of age on management and outcome of acute coronary syndrome: observations from the Global Registry of Acute Coronary Events (GRACE). Am. Heart J. 2005;149(1):67-73. https://doi.org/10.1016/j.ahj.2004.06.003.
  • Roe M.T., Goodman S.G., Ohman E.M., Stevens S.R., Hochman J.S., Gottlieb S. et al. Elderly patients with acute coronary syndromes managed without revascularization: insights into the safety of long-term dual antiplatelet therapy with reduced-dose prasugrel versus standard-dose clopidogrel. Circulation. 2013;128(8):823-833. https://doi.org/10.1161/CIRCULATIONAHA.113.002303.
  • Mehran R., Pocock S., Nikolsky E., Dangas G.D., Clayton T., Claessen B.E. et al. Impact of bleeding on mortality after percutaneous coronary intervention results from a patient-level pooled analysis of the REPLACE-2 (randomized evaluation of PCI linking angiomax to reduced clinical events), ACUITY (acute catheterization and urgent intervention triage strategy), and HORIZONS-AMI (harmonizing outcomes with revascularization and stents in acute myocardial infarction) trials. JACC Cardiovasc. Interv. 2011;4(6):654-64. https://doi.org/10.1016/j.jcin.2011.02.011.
  • Krijthe B.P., Kunst A., Benjamin E.J., Lip G.Y., Franco O.H., Hofman A. et al. Projections on the number of individuals with atrial fibrillation in the European Union, from 2000 to 2060. Eur. Heart J. 2013;34:2746-2751. https://doi.org/10.1093/eurheartj/eht280.
  • Di Carlo A., Bellino L., Consoli D., Mori F., Zaninelli A., Baldereschi M. et al. Prevalence of atrial fibrillation in the Italian elderly population and projections from 2020 to 2060 for Italy and the European Union: the FAI Project. Europace. 2019;21(10):1468-1475. https://doi.org/10.1093/europace/euz141.
  • Kannel W.B., Wolf P.A., Castelli W.P., D’Agostino R.B. Fibrinogen and risk of cardiovascular disease. The Framingham Study. JAMA. 1987;258(9):1183-6.
  • Balleisen L., Bailey J., Epping P.H., Schulte H., van de Loo J. Epidemiological study on factor VII, factor VIII and fibrinogen in an industrial population: I. Baseline data on the relation to age, gender, body-weight, smoking, alcohol, pill-using, and menopause. Thromb. Haemost. 1985;54(2):475-479.
  • Conlan M.G., Folsom A.R., Finch A., Davis C.E., Sorlie P., Marcucci G. et al. Associations of factor VIII and von Willebrand factor with age, race, sex, and risk factors for atherosclerosis. The Atherosclerosis Risk in Communities (ARIC) Study. Thromb. Haemost. 1993;70(3):380-385.
  • Quinn T.J., Alghamdi J., Padmanabhan S., Porteous D.J., Smith B.H., Hocking L. et al. Association between cognition and gene polymorphisms involved in thrombosis and haemostasis. Age (Dordr). 2015;37(4):9820. https://doi.org/10.1007/s11357-015-9820-y.
  • Berge T., Ulimoen S.R., Enger S., Arnesen H., Seljeflot I., Tveit A. Impact of atrial fibrillation on inflammatory and fibrinolytic variables in the elderly. Scand. J. Clin. Lab. Invest. 2013;73(4):326-33. https://doi.org/10.3109/00365513.2013.780093.
  • James S.K., Armstrong P., Barnathan E., Califf R., Lindahl B., Siegbahn A. et al. Troponin and C-reactive protein have different relations to subsequent mortality and myocardial infarction after acute coronary syndrome: a GUSTO-IV substudy. J. Am. Coll. Cardiol. 2003;41(6):916-924. https://doi.org/10.1016/s0735-1097(02)02969-8.
  • Ndrepepa G., Neumann F.J., Schulz S., Fusaro M., Cassese S., Byrne R.A. et al. Incidence and prognostic value of bleeding after percutaneous coronary intervention in patients older than 75 years of age. Catheter Cardiovasc. Interv. 2014;83(2):182-189. https://doi.org/10.1002/ccd.25189.
  • Hirlekar G., Libungan B., Karlsson T., Bäck M., Herlitz J., Albertsson P. Percutaneous coronary intervention in the very elderly with NSTE-ACS: the randomized 80+ study. Scand. Cardiovasc. J. 2020;54(5):315-321. https://doi.org/10.1080/14017431.2020.1781243.
  • Valgimigli M., Frigoli E., Heg D., Tijssen J., Jüni P., Vranckx P. et al. Dual Antiplatelet Therapy after PCI in Patients at High Bleeding Risk. N. Engl. J. Med. 2021;385(18):1643-1655. https://doi.org/10.1056/NEJMoa2108749.
  • Cockburn J., Hildick-Smith D., Trivedi U., de Belder A. Coronary revascularisation in the elderly. Heart. 2017;103(4):316-324. https://doi.org/10.1136/heartjnl-2015-308999.
  • Ahmed O.E., Abohamr S.I., Alharbi S.A., Aldrewesh D.A., Allihimy A.S., Alkuraydis S.A. et al. In-hospital mortality of acute coronary syndrome in elderly patients. Saudi Med. J. 2019;40(10):1003-1007. https://doi.org/10.15537/smj.2019.10.24583.
  • Fox K.A., Dabbous O.H., Goldberg R.J., Pieper K.S., Eagle K.A., Van de Werf F. et al. Prediction of risk of death and myocardial infarction in the six months after presentation with acute coronary syndrome: prospective multinational observational study (GRACE). BMJ. 2006;333(7578):1091. https://doi.org/10.1136/bmj.38985.646481.55.
  • Alexander K.P., Roe M.T., Chen A.Y., Lytle B.L., Pollack C.V.Jr., Foody J.M. et al. Evolution in cardiovascular care for elderly patients with non-ST-segment elevation acute coronary syndromes: results from the CRUSADE National Quality Improvement Initiative. J. Am. Coll. Cardiol. 2005;46(8):1479-1487. https://doi.org/10.1016/j.jacc.2005.05.084.
  • Rajani R., Lindblom M., Dixon G., Khawaja M.Z., Hildick-Smith D., Holmberg S. et al. Evolving trends in percutaneous coronary intervention. Br. J. Cardiol. 2011;18:73-76.
  • Rathod K.S., Koganti S., Jain A.K., Astroulakis Z., Lim P., Rakhit R. et al. Complete Versus Culprit-Only Lesion Intervention in Patients With Acute Coronary Syndromes. J. Am. Coll. Cardiol. 2018;72(17):1989-1999. https://doi.org/10.1016/j.jacc.2018.07.089.
  • Kvakkestad K.M., Gran J.M., Eritsland J., Holst Hansen C., Fossum E., Andersen G.Ø. et al. Long-Term Survival after Invasive or Conservative Strategy in Elderly Patients with non-ST-Elevation Myocardial Infarction: A Prospective Cohort Study. Cardiology. 2019;144(3-4):79-89. https://doi.org/10.1159/000503442.
  • Badimon L., Bugiardini R., Cubedo J. Pathophysiology of acute coronary syndromes in the elderly. Int. J. Cardiol. 2016;222:1105-1109. https://doi.org/10.1016/j.ijcard.2016.07.205.
  • Guedeney P., Claessen B.E., Mehran R., Mintz G.S., Liu M., Sorrentino S. et al. Coronary Calcification and Long-Term Outcomes According to Drug-Eluting Stent Generation. JACC Cardiovasc Interv. 2020;13(12):1417-1428. https://doi.org/10.1016/j.jcin.2020.03.053.
  • Schenker M.P., Dorbala S., Hong E.C., Rybicki F.J., Hachamovitch R., Kwong R.Y. et al. Interrelation of coronary calcification, myocardial ischemia, and outcomes in patients with intermediate likelihood of coronary artery disease: a combined positron emission tomography/computed tomography study. Circulation. 2008;117(13):1693-1700. https://doi.org/10.1161/CIRCULATIONAHA.107.717512.
  • Kumar S., McDaniel M., Samady H., Forouzandeh F. Contemporary Revascularization Dilemmas in Older Adults. J. Am. Heart Assoc. 2020;9(3):e014477. https://doi.org/10.1161/JAHA.119.014477.
  • Savonitto S., Cavallini C., Petronio A.S., Murena E., Antonicelli R., Sacco A. et al. Italian Elderly ACS Trial Investigators. Early aggressive versus initially conservative treatment in elderly patients with non-ST-segment elevation acute coronary syndrome: a randomized controlled trial. JACC Cardiovasc. Interv. 2012;5(9):906-916. https://doi.org/10.1016/j.jcin.2012.06.008.
  • Tegn N., Abdelnoor M., Aaberge L., Endresen K., Smith P., Aakhus S. et al. After Eighty study investigators. Invasive versus conservative strategy in patients aged 80 years or older with non-ST-elevation myocardial infarction or unstable angina pectoris (After Eighty study): an open-label randomised controlled trial. Lancet. 2016;387(10023):1057-1065. https://doi.org/10.1016/S0140-6736(15)01166-6.
  • Garg A., Garg L., Agarwal M., Rout A., Raheja H., Agrawal S. et al. Routine Invasive Versus Selective Invasive Strategy in Elderly Patients Older Than 75 Years With Non-ST-Segment Elevation Acute Coronary Syndrome: A Systematic Review and Meta-Analysis. Mayo. Clin. Proc. 2018;93(4):436-444. https://doi.org/10.1016/j.mayocp.2017.11.022.
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