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Association of Dementia with Adverse Outcomes in Older Patients with Acute Myocardial Infarction in the ICU.
Luo, Li; Jian, Linhao; Zhou, Quan; Duan, Xiangjie; Ge, Liangqing.
Afiliación
  • Luo L; Department of the First Clinical College, Jinan University.
  • Jian L; Department of Cardiology, Changde Hospital, Xiangya School of Medicine, Central South University.
  • Zhou Q; Department of Cardiology, Changde Hospital, Xiangya School of Medicine, Central South University.
  • Duan X; Department of Science and Education, Changde Hospital, Xiangya School of Medicine, Central South University.
  • Ge L; Department of Infectious Diseases, Changde Hospital, Xiangya School of Medicine, Central South University.
Int Heart J ; 65(4): 601-611, 2024 Jul 31.
Article en En | MEDLINE | ID: mdl-39010226
ABSTRACT
Dementia limits timely revascularization in individuals with acute myocardial infarction (AMI). However, it remains unclear whether dementia affects prognosis negatively in older individuals with AMI in the intensive care unit (ICU). This research aimed to evaluate the dementia effect on the outcomes in individuals with AMI in ICU.Data from 3,582 patients aged ≥ 65 years with AMI in ICU from the Medical Information Mart for Intensive Care IV (MIMIC IV) database were evaluated. The independent variable was dementia at baseline, and the primary finding was death from any cause during follow-up. A 11 propensity score matching (PSM) showed 208 participants with and without dementia. The correlation between dementia and poor prognosis of AMI was verified using a double-robust estimation method.In the PSM cohort, the 30-day all-cause mortality was 37.50% and 33.17% in the dementia and non-dementia groups (P = 0.356), respectively, and the 1-year all-cause mortality was 61.06% and 51.44%, respectively (P = 0.048). Cox regression analysis showed no association between dementia and elevated 30-day (hazard ratio [HR] 1.15, 95% confidence interval [CI] 0.84, 1.60) and 1-year (HR 1.28, 95% CI 0.99, 1.66) all-cause mortality after AMI. Similarly, dementia was not connected with in-hospital mortality, bleeding, or stroke after AMI. Interaction analysis showed that 1-year all-cause mortality was 48.00% higher in individuals with dementia and diabetic complications than in those without diabetic complications.Dementia is not an independent risk factor for adverse outcomes in AMI. Thus, it may be inappropriate to include dementia as a contraindication for invasive AMI therapy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Demencia / Unidades de Cuidados Intensivos / Infarto del Miocardio Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Int Heart J Asunto de la revista: CARDIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Japón
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Demencia / Unidades de Cuidados Intensivos / Infarto del Miocardio Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Int Heart J Asunto de la revista: CARDIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Japón