Percutaneous coronary intervention in the very elderly with NSTE-ACS: the randomized 80+ study.

The treatment strategy in the very elderly with NSTE-ACS is debated, as they are often under-represented in clinical trials. The aim of this multicenter randomized controlled trial was to compare invasive and conservative strategies in the very elderly with NSTE-ACS. We randomly assigned patients ≥ 80 years of age with NSTE-ACS to an invasive strategy with coronary angiography and optimal medical treatment or a conservative strategy with only optimal medical treatment.

Identifying out-of-hospital cardiac arrest patients with no chance of survival: An independent validation of prediction rules.

Background: The Basic life support (BLS) and Advanced life support (ALS) are known prediction rules for termination of resuscitation (TOR) in out-of-hospital cardiac arrest (OHCA). Recently, a new rule was developed by Jabre et al. We aimed to independently validate and compare the predictive accuracy of these rules.

Prognostic impact of percutaneous coronary intervention in octogenarians with non-ST elevation myocardial infarction: A report from SWEDEHEART.

Aims: Percutaneous coronary intervention (PCI) improves outcomes in non-ST elevation acute coronary syndromes (NSTE-ACSs). Octogenarians, however, were underrepresented in the pivotal trials. This study aimed to assess the effect of PCI in patients ≥80 years old.

Out-of-hospital cardiac arrest in the elderly: A large-scale population-based study.

Background: There is little information on elderly people who suffer from out-of-hospital cardiac arrest (OHCA).

Aim: To determine 30-day mortality and neurological outcome in elderly patients with OHCA.

Methods: OHCA patients ≥ 70 years of age who were registered in the Swedish Cardiopulmonary Resuscitation Register between 1990 and 2013 were included and divided into three age categories (70-79, 80-89, and ≥ 90 years).

Angiographic findings and survival in patients undergoing coronary angiography due to sudden cardiac arrest in western Sweden.

Aim: Sudden cardiac arrest (SCA) accounts for more than half of all deaths from coronary heart disease. Time to return of spontaneous circulation is the most important determinant of outcome but successful resuscitation also requires percutaneous coronary intervention in selected patients. However, proper selection of patients is difficult.

Elderly patients with myocardial infarction selected for conservative or invasive treatment strategy.

Background: There are limited data on patients aged >75 years with myocardial infarction (MI), especially those who are treated conservatively.

Hypothesis: There are important differences in the clinical characteristics and outcome between elderly MI patients selected for invasive or conservative treatment strategy.

Methods: A total of 1,413 elderly patients (>75 years old) admitted to Sahlgrenska University Hospital, Gothenburg, Sweden with a final diagnosis of acute MI in 2001 or 2007, were divided into two groups, those who underwent a conservative treatment strategy (conservative group [CG], n=1,169) and those who underwent coronary angiography and were revascularized if indicated (invasive group [IG], n=244).

Coronary angioplasty in octogenarians with emergent coronary syndromes: study protocol for a randomized controlled trial.

Background: Invasive treatment (coronary angiography and intervention if feasible) of patients with acute coronary syndrome (ACS) has been shown to lead to better outcomes than medical therapy alone, but the elderly have been under-represented in many of the studies. In the elderly, medical therapy is common in ACS. Fear of complications related to the procedure and unclear benefit in older patients are common reasons for invasive procedures being withheld.

Delay and inequality in treatment of the elderly with suspected acute coronary syndrome.

Background/objectives: The aim of this study is to determine differences between elderly patients (≥80 years) and younger patients with suspected acute coronary syndrome (ACS) regarding delay times before diagnostic tests and treatments.

Methods: All patients with chest pain who were admitted to a hospital in the Gothenburg area were included consecutively over a 3-month period. They were divided into an elderly group (≥80 years) and a reference group (<80 years).

Prognosis of elderly patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention in 2001 to 2011: A report from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) registry.

Background: Elderly patients constitute a growing part of the population presenting with ST-elevation myocardial infarction (STEMI). The use of primary percutaneous coronary intervention (PCI) in this high-risk population remains poorly investigated.

Methods: Using the Swedish Coronary Angiography and Angioplasty Registry (SCAAR), we identified consecutive patients with STEMI 80 years or older undergoing primary PCI during a 10-year period.

Successful percutaneous coronary intervention during cardiac arrest with use of an automated chest compression device: a case report.

Ventricular tachycardia or fibrillation (VT/VF) in patients with ST-elevation myocardial infarction (STEMI) is associated with poor prognosis. Performing manual chest compressions is a serious obstacle for treatment with percutaneous coronary intervention (PCI). Here we introduce a case with refractory VT/VF where the patient was successfully treated with an automated chest compression device, which made revascularization with PCI possible.

Does the timing of treatment with intra-aortic balloon counterpulsation in cardiogenic shock due to ST-elevation myocardial infarction affect survival?

Background: Intra-aortic balloon pump (IABP) counterpulsation and primary percutaneous coronary intervention (PCI) are standard treatment modalities in cardiogenic shock (CS) complicating acute myocardial infarction. The aim of this study was to investigate the impact of the timing of IABP treatment start in relation to PCI procedure.

Methods: Data were obtained from the SCAAR registry (Swedish Coronary Angiography and Angioplasty Registry) about 139 consecutive patients with CS due to ST-elevation myocardial infarction (STEMI) who received IABP treatment.

Secondary prevention in coronary artery disease. Achieved goals and possibilities for improvements.

Aim: To describe presence of risk indicators of recurrence 6 months after hospitalisation due to coronary artery disease at a university clinic.

Methods: The presence of risk indicators, including tobacco use, lipid levels, blood pressure and glucometabolic status, including 24-hour blood pressure monitoring and an oral glucose-tolerance test, was analysed.

Results: Of 1465 patients who were screened, 402 took part in the survey (50% previous myocardial infarction and 50% angina pectoris).

Quality of life 15 years after coronary artery bypass grafting.

Objectives: To describe changes in quality of life (QoL) during 15 years after coronary artery bypass grafting (CABG) and prediction of impaired QoL after 15 years.

Methods: All patients in western Sweden who underwent primary CABG without simultaneous valve surgery between 1988 and 1991 were included. QoL during a period of 15 years after CABG was evaluated with three instruments: the Nottingham Health Profile, the Psychological General Well-Being Index, and the Physical Activity Score.

[Primary percutaneous coronary interventions in Iceland].

Introduction: Acute coronary angiography with primary percutaneous coronary intervention (PCI), if executed with sufficient expertise and without undue delay, is the best therapy for patients with ST-elevation myocardial infarction (STEMI). At Landspitali-University Hospital 24 hour on-call service has been provided since December the 1st 2003. This hospital is the single center for all coronary catherizations in Iceland.