Outcome in elderly patients undergoing primary coronary intervention for acute myocardial infarction: results from the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) trial

Circulation
Giulio GuagliumiEulogio Garcia

Abstract

Biological age is a strong determinant of prognosis in patients with acute myocardial infarction (AMI). We sought to examine the impact of age after primary percutaneous coronary intervention in AMI and to determine whether routine coronary stent implantation and/or platelet glycoprotein IIb/IIIa inhibitors improve clinical outcomes in elderly patients after primary angioplasty. In the CADILLAC trial, 2082 patients with AMI were randomized to balloon angioplasty, angioplasty plus abciximab, stenting alone, or stenting plus abciximab. No patient was excluded on the basis of advanced age; patients ranging from 21 to 95 years of age were enrolled. One-year mortality increased for each decile of age, exponentially after 65 years of age (1.6% for patients <55 years, 2.1% for 55 to 65 years, 7.1% for 65 to 75 years, 11.1% for patients >75 years; P<0.0001). Elderly patients also had increased rates of stroke and major bleeding compared with their younger counterparts. Among elderly patients (> or =65 years), 1-year rates of ischemic target revascularization (7.0% versus 17.6%; P<0.0001) and subacute or late thrombosis (0% versus 2.2%; P=0.005) were reduced with stenting compared with balloon angioplasty. Routine abciximab administrati...Continue Reading

References

Sep 16, 1992·JAMA : the Journal of the American Medical Association·J H GurwitzJ Avorn
Feb 11, 1999·Journal of the American College of Cardiology·D R HolmesE J Topol
Aug 4, 1999·JAMA : the Journal of the American Medical Association·A K BergerN R Every
Sep 29, 1999·American Heart Journal·D AntoniucciP F Fazzini
Aug 10, 2000·Journal of the American College of Cardiology·A K BergerH M Krumholz
Oct 12, 2000·Journal of the American College of Cardiology·E L HannanB D McCallister
Jun 23, 2001·The New England Journal of Medicine·G MontalescotUNKNOWN ADMIRAL Investigators. Abciximab before Direct Angioplasty and Stenting in Myocardial Infarction Regarding Acute and Long-Te
Aug 10, 2001·JAMA : the Journal of the American Medical Association·P Y LeeE D Peterson
Mar 29, 2002·The New England Journal of Medicine·Gregg W StoneUNKNOWN Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) Investigators
May 8, 2002·Journal of Thrombosis and Thrombolysis·Karen L KaplanVictor J Marder
May 22, 2002·Circulation·Michelle M GrahamUNKNOWN Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) Investigators
Jun 1, 2002·Journal of the American College of Cardiology·Menko-Jan de BoerUNKNOWN Zwolle Myocardial Infarction Study Group
Oct 26, 2002·The American Journal of Cardiology·Miwako ShiharaUNKNOWN Japanese Coronary Invention Study (JCIS) Group

❮ Previous
Next ❯

Citations

Mar 5, 2008·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·R P VermeulenF Zijlstra
Oct 22, 2011·Current Treatment Options in Cardiovascular Medicine·Davide Capodanno, Dominick J Angiolillo
Jul 25, 2009·JACC. Cardiovascular Interventions·P Michael GrossmanUNKNOWN Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2)
Jul 18, 2006·Heart·Jan KaehlerChristian W Hamm
May 12, 2012·Circulation. Cardiovascular Quality and Outcomes·John A DodsonHarlan M Krumholz
Dec 8, 2009·Clinical Interventions in Aging·Maan Jokhadar, Nanette K Wenger
Oct 24, 2007·Drugs & Aging·Zenon S KyriakidesKonstantinos Kontaras
May 25, 2006·Journal of Cardiovascular Medicine·Alessio La MannaCarlo Di Mario
Oct 29, 2009·Journal of Cardiovascular Medicine·Stefano SavonittoEmanuela Piccaluga
Dec 21, 2012·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Lars JakobsenSøren P Johnsen
Jul 12, 2011·Cardiovascular Drugs and Therapy·Renicus S HermanidesUNKNOWN On-TIME 2 trial investigators
Apr 15, 2010·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·L A A MoonenN H J Pijls
Jul 9, 2008·Acute Cardiac Care·Francesco LiistroLeonardo Bolognese
May 15, 2013·The American Journal of Cardiology·Giuseppe De LucaUNKNOWN DESERT cooperation
Oct 4, 2011·The American Journal of Medicine·Joseph S Alpert
Nov 3, 2010·The American Journal of Medicine·Joseph S Alpert
Jul 24, 2015·International Journal of Clinical Practice·R A BrownG Y H Lip
Feb 21, 2009·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Elisabetta VaraniAleardo Maresta
Oct 6, 2006·Journal of Interventional Cardiology·Kevin C FloydCraig A Thompson
Mar 1, 2008·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Michael S LeeJonathan Tobis
Sep 6, 2007·The American Journal of Geriatric Cardiology·Lloyd W Klein
Jan 30, 2013·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Dariusz DudekGregg W Stone
Nov 9, 2011·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Glenn N LevineUNKNOWN Society for Cardiovascular Angiography and Interventions
Oct 26, 2010·Annales de cardiologie et d'angéiologie·A-C Martin, J Monsegu
Mar 29, 2008·American Heart Journal·Pieter J VlaarDavid R Holmes
Jul 15, 2006·International Journal of Cardiology·David HarpazUNKNOWN Israeli Working Group on Intensive Cardiac Care, Israel Heart Society
Apr 16, 2016·Journal of the American College of Cardiology·Michael W RichUNKNOWN American College of Cardiology; and American Geriatrics Society
Nov 13, 2010·Journal of the American College of Cardiology·Davide Capodanno, Dominick J Angiolillo
Apr 6, 2005·Journal of the American College of Cardiology·William W O'NeillCindy L Grines

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