Study Data from Mailman School of Public Health Update Knowledge of Heart Attack (Temporal Pattern of CABG and PCI after Non-ST Elevation Myocardial Infarction Among Elderly Patients from NHDS)

Hospital & Nursing Home Daily

2020 MAR 24 (NewsRx) -- By a News Reporter-Staff News Editor at Hospital & Nursing Home Daily -- Research findings on Heart Disorders and Diseases - Heart Attack are discussed in a new report. According to news reporting originating in New York City, United States, by NewsRx journalists, research stated, “Background Management of elderly patients with Non-ST Elevation Myocardial Infarction (NSTEMI) continues to be a source of controversy due to underrepresentation in large-scale clinical trials and the increased risk of adverse outcomes after both invasive (Percutaneous coronary intervention and Coronary artery bypass grafting) and non-invasive therapies. Recent randomized clinical trials have shown improved short term and intermediate term outcomes among high risk NSTEMI patients receiving early invasive management versus conservative medical management.”

The news reporters obtained a quote from the research from the Mailman School of Public Health, “However, how this is reflected in U.S. clinical practice for elderly patients has not been reported. To identify the trend of invasive management in patients with NSTEMI, particularly among elderly population. We used data from National Hospital Discharge Survey to identify all adult patients with an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code for NSTEMI from the years 2005 to 2009. The goal was to investigate the trends in time of invasive therapy for patients diagnosed with NSTEMI. We then stratified the patients according to age >65 and 65, and compared the temporal trends between two age groups. Among 21,306 patients diagnosed with NSTEMI between 2005 and 2009, the median age was 73 years (IQR: 61-82 years), 54% were males and 57% were White. The proportions of patients age >65 years receiving invasive management (21%, N=13978) was significantly lower than those age 65 (41%, N=7328) (p <0.001). Moreover, in both age groups, the proportion of patients receiving early invasive management decreased substantially over time (p <0.001). Despite numerous studies promoting the use of early invasive management for NSTEMI patients, the proportion of patients receiving invasive intervention gradually decreased from 2005-2009, more so in elderly population. The decrease seen in overall proportion of patients receiving invasive therapy could be associated with older median age of NSTEMI patients; 73 years (IQR: 61-82).”

According to the news reporters, the research concluded: “Our future analyses will investigate if this trend maintains after adjusting for other factors (sex, co-morbid conditions, insurance status, year of procedure, hospital region, and hospital bed-size) thought to be associated with the management of NSTEMI in elderly patients.”

For more information on this research see: Temporal Pattern of CABG and PCI after Non-ST Elevation Myocardial Infarction Among Elderly Patients from NHDS. Cureus, 2020;12(1):e6814.

Our news correspondents report that additional information may be obtained by contacting C. Chiuzan, Biostatistician, Mailman School of Public Health, New York City, United States. Additional authors for this research include M.U. Siddiqui, M.D. Siddiqui, S.S. Ali, Z. Naeem and S. Islam.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.7759/cureus.6814. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.