Heart attack victims over 65 treated differently; suffer worse outcomes but have lower hospital charges, new research finds

April 06, 2019

ARLINGTON, Virginia, April 6, 2019 -- Heart attack victims over age 65 are less likely than younger patients to receive timely percutaneous coronary intervention to open their blocked heart arteries, according to preliminary research presented at the American Heart Association's Quailty of Care and Outcomes Research Scientific Sessions 2019, a premier global exchange of the latest advances in quality of care and outcomes research in cardiovascular disease and stroke for researchers, healthcare professionals and policymakers.

In the study, older heart attack patients suffered more complications, such as shock and heart failure, had longer hospital stays and an increased chance of death. Despite staying in the hospital on average a half-day longer, older patients had lower total charges, something the researchers said could be attributed to the lack of undergoing more costly interventions such as percutaneous coronary intervention (PCI).

PCI, often referred to as angioplasty, is a non-surgical procedure used to treat narrow or blocked coronary arteries. During the procedure, special tubing with an attached deflated balloon is inserted into the blockage and the balloon is inflated to push open the blockage. Sometimes a stent may be placed during the procedure to keep the blood vessel open.

"Our study found that seniors were less likely to undergo PCI for a heart attack and if they do receive the procedure it's not within the optimal time for the best possible outcome," said Wojciech Rzechorzek, M.D., lead study author and a resident at Mount Sinai St. Luke's and Mount Sinai West Hospital in New York. "Their prognosis is worse than for younger patients with the same conditions, and this lack of treatment or delay in treatment could be a factor."

Researchers used the 2014 Nationwide Inpatient Sample to review records of 115,042 heart attack patients, 54 percent of whom were over 65.

The average age of the older group was 78. They were more likely than their younger counterparts to have high blood pressure, heart failure, chronic kidney disease and diabetes.

Researchers found, compared to younger patients, older patients were: There appeared to be no difference between the two groups in the use of drugs or surgery to open blocked arteries.

Older patients were more likely to fare worse. Compared to younger counterparts they were: Despite older patients having to stay in the hospital longer, their adjusted total hospital charges were lower by approximately $3,231 per stay compared to younger patients.

"I am surprised that the costs of stay are lower despite the increased length of stay, but this could be primarily driven by decreased use of PCI, which is an expensive procedure," Rzechorzek said.

The researchers said because this was a retrospective analysis based on a very limited data set, further research is needed.

"Elderly patients are underrepresented in clinical trials, and we need more prospective studies evaluating the impact of PCI on outcomes," Rzechorzek said.
-end-
Co-authors are Kirtipal Bhatia, M.D.; Michel Skaf, M.D.; Jan Lopes, M.D.; and Eyal Herzog, M.D. Author disclosures are on the abstract.

The authors reported no funding for this study.

Note: Scientific presentation is 2:30 p.m. ET, Saturday, April 6, 2019.

Additional Resources: Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position. The association makes no representation or warranty as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at https://www.heart.org/en/about-us/aha-financial-information.

About the American Heart Association

The American Heart Association is a leading force for a world of longer, healthier lives. With nearly a century of lifesaving work, the Dallas-based association is dedicated to ensuring equitable health for all. We are a trustworthy source empowering people to improve their heart health, brain health and well-being. We collaborate with numerous organizations and millions of volunteers to fund innovative research, advocate for stronger public health policies, and share lifesaving resources and information. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.

American Heart Association

Related Heart Failure Articles from Brightsurf:

Top Science Tip Sheet on heart failure, heart muscle cells, heart attack and atrial fibrillation results
Newly discovered pathway may have potential for treating heart failure - New research model helps predict heart muscle cells' impact on heart function after injury - New mass spectrometry approach generates libraries of glycans in human heart tissue - Understanding heart damage after heart attack and treatment may provide clues for prevention - Understanding atrial fibrillation's effects on heart cells may help find treatments - New research may lead to therapy for heart failure caused by ICI cancer medication

Machining the heart: New predictor for helping to beat chronic heart failure
Researchers from Kanazawa University have used machine learning to predict which classes of chronic heart failure patients are most likely to experience heart failure death, and which are most likely to develop an arrhythmic death or sudden cardiac death.

Heart attacks, heart failure, stroke: COVID-19's dangerous cardiovascular complications
A new guide from emergency medicine doctors details the potentially deadly cardiovascular complications COVID-19 can cause.

Autoimmunity-associated heart dilation tied to heart-failure risk in type 1 diabetes
In people with type 1 diabetes without known cardiovascular disease, the presence of autoantibodies against heart muscle proteins was associated with cardiac magnetic resonance (CMR) imaging evidence of increased volume of the left ventricle (the heart's main pumping chamber), increased muscle mass, and reduced pumping function (ejection fraction), features that are associated with higher risk of failure in the general population

Transcendental Meditation prevents abnormal enlargement of the heart, reduces chronic heart failure
A randomized controlled study recently published in the Hypertension issue of Ethnicity & Disease found the Transcendental Meditation (TM) technique helps prevent abnormal enlargement of the heart compared to health education (HE) controls.

Beta blocker use identified as hospitalization risk factor in 'stiff heart' heart failure
A new study links the use of beta-blockers to heart failure hospitalizations among those with the common 'stiff heart' heart failure subtype.

Type 2 diabetes may affect heart structure and increase complications and death among heart failure patients of Asian ethnicity
The combination of heart failure and Type 2 diabetes can lead to structural changes in the heart, poorer quality of life and increased risk of death, according to a multi-country study in Asia.

Preventive drug therapy may increase right-sided heart failure risk in patients who receive heart devices
Patients treated preemptively with drugs to reduce the risk of right-sided heart failure after heart device implantation may experience the opposite effect and develop heart failure and post-operative bleeding more often than patients not receiving the drugs.

How the enzyme lipoxygenase drives heart failure after heart attacks
Heart failure after a heart attack is a global epidemic leading to heart failure pathology.

Novel heart pump shows superior outcomes in advanced heart failure
Severely ill patients with advanced heart failure who received a novel heart pump -- the HeartMate 3 left ventricular assist device (LVAD) -- suffered significantly fewer strokes, pump-related blood clots and bleeding episodes after two years, compared with similar patients who received an older, more established pump, according to research presented at the American College of Cardiology's 68th Annual Scientific Session.

Read More: Heart Failure News and Heart Failure Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.