Supplement
Observational studies reporting outcomes of elderly (≥75 year-old) patients with AMI-CS
1. Antoniucci D, Valenti R, Santoro GM, Bolognese L, Trapani M, Moschi G, Fazzini PF. Systematic direct angioplasty and stent-supported direct angioplasty therapy for cardiogenic shock complicating acute myocardial infarction: in-hospital and long-term survival. J Am CollCardiol 1998;31:294-300.
2.Dzavik V, Burton JR, Kee C, Teo KK, Ignaszewski A, Lucas AR, Tymchak WJ. Changing practice patterns in the management of acute myocardial infarction complicated by cardiogenic shock: elderly compared with younger patients. Can J Cardiol 1998;14:923-30.
3.Dauerman HL, Goldberg RJ, Malinski M, Yarzebski J, Lessard D, Gore JM. Outcomes and early revascularization for patients > or = 65 years of age with cardiogenic shock. Am J Cardiol 2001;87:844-8.
4. Yip HK, Wu CJ, Chang HW, Hang CL, Fang CY, Hsieh YK, Yang CH, Chen CJ, Yeh KH, Chua S, Fu M, Chen MC. Comparison of primary angioplasty and conservative treatment on short- and long-term outcome in octogenarian or older patients with acute myocardial infarction. Jpn Heart J 2002;43:463-74.
5.Antoniucci D, Valenti R, Migliorini A, Moschi G, Parodi G, Dovellini EV, Bolognese L, Santoro GM. Comparison of impact of emergency percutaneous revascularization on outcome of patients > or =75 to those < 75 years of age with acute myocardial infarction complicated by cardiogenic shock. Am J Cardiol 2003;91:1458-61, A6.
6.Dauerman HL, Ryan TJ, Jr., Piper WD, Kellett MA, Shubrooks SJ, Robb JF, Hearne MJ, Watkins MW, Hettleman BD, Silver MT, Niles NW, Malenka DJ. Outcomes of percutaneous coronary intervention among elderly patients in cardiogenic shock: a multicenter, decade-long experience. J Invasive Cardiol 2003;15:380-4.
7. Tedesco JV, Williams BA, Wright RS, Reeder GS, Dvorak D, Kopecky SL, Miller WL. Baseline comorbidities and treatment strategy in elderly patients are associated with outcome of cardiogenic shock in a community-based population. Am Heart J 2003;146:472-8.
8.Zielinska M, Bolinska H, Kaczmarek K, Krekora J, Kuczborski M, Kosmider M, Koniarek W. Acute myocardial infarction in the elderly. Is primary coronary angioplasty the treatment of choice? In-hospital follow-up results.Kardiol Pol 2004;60:95-103; discussion 104.
9.Assali AR, Iakobishvili Z, Zafrir N, Solodky A, Teplitsky I, Rechavia E, Butto N, Shor N, Hasdai D, Fuchs S, Battler A, Kornowski R. Characteristics and clinical outcomes of patients with cardiogenic shock complicating acute myocardial infarction treated by emergent coronary angioplasty. Int J CardiovascIntervent 2005;7:193-8.
10.Babaev A, Frederick PD, Pasta DJ, Every N, Sichrovsky T, Hochman JS. Trends in management and outcomes of patients with acute myocardial infarction complicated by cardiogenic shock.JAMA 2005;294:448-54.
11.Dangelser G, Gottwalles Y, Huk M, de Poli F, Levai L, Boulenc JM, Monassier JP, Jacquemin L, Couppie P, Hanssen M. [Acute ST-elevation myocardial infarction in the elderly (>75 years). Results from a regional multicenter study]. Presse Med 2005;34:983-9.
12.Iakobishvili Z, Behar S, Boyko V, Battler A, Hasdai D. Does current treatment of cardiogenic shock complicating the acute coronary syndromes comply with guidelines? Am Heart J 2005;149:98-103.
13. Klein LW, Shaw RE, Krone RJ, Brindis RG, Anderson HV, Block PC, McKay CR, Hewitt K, Weintraub WS. Mortality after emergent percutaneous coronary intervention in cardiogenic shock secondary to acute myocardial infarction and usefulness of a mortality prediction model.Am J Cardiol 2005;96:35-41.
14. Sutton AG, Finn P, Hall JA, Harcombe AA, Wright RA, de Belder MA. Predictors of outcome after percutaneous treatment for cardiogenic shock.Heart 2005;91:339-44.
15.Migliorini A, Moschi G, Valenti R, Parodi G, Dovellini EV, Carrabba N, Buonamici P, Antoniucci D. Routine percutaneous coronary intervention in elderly patients with cardiogenic shock complicating acute myocardial infarction. Am Heart J 2006;152:903-8.
16. Sakai K, Nakagawa Y, Soga Y, Ando K, Yokoi H, Iwabuchi M, Yasumoto H, Nosaka H, Nobuyoshi M. Comparison of 30-day outcomes in patients <75 years of age versus >or=75 years of age with acute myocardial infarction treated by primary coronary angioplasty. Am J Cardiol 2006;98:1018-21.
17.Kunadian B, Vijayalakshmi K, Dunning J, Thornley AR, Sutton AG, Muir DF, Wright RA, Hall JA, de Belder MA. Should patients in cardiogenic shock undergo rescue angioplasty after failed fibrinolysis: comparison of primary versus rescue angioplasty in cardiogenic shock patients. J Invasive Cardiol 2007;19:217-23.
18. Valente S, Lazzeri C, Vecchio S, Giglioli C, Margheri M, Bernardo P, Comeglio M, Chiocchini S, Gensini GF. Predictors of in-hospital mortality after percutaneous coronary intervention for cardiogenic shock.Int J Cardiol 2007;114:176-82.
19.Widimsky P, Motovska Z, Bilkova D, Aschermann M, Groch L, Zelizko M. The impact of age and Killip class on outcomes of primary percutaneous coronary intervention.Insight from the PRAGUE-1 and -2 trials and registry.EuroIntervention 2007;2:481-6.
20.Guo L, Mai X, Deng J, Liu A, Bu L, Wang H. Early percutaneous intervention improves survival in elderly patients with acute myocardial infarction complicated by cardiogenic shock. Kardiol Pol 2008;66:722-6; discussion 727-8.
21.Samadi A, Le Feuvre C, Allali Y, Collet JP, Barthelemy O, Beygui F, Helft G, Montalescot G, Metzger JP. Medium-term survival after primary angioplasty for myocardial infarction complicated by cardiogenic shock after the age of 75 years.Arch Cardiovasc Dis 2008;101:175-80.
22. Amin AP, Nathan S, Prodduturi P, D'Silva O, Gupta A, Kumar A, Senter S, Mamtani M, Kulkarni H, Klein LW, Kelly RF. Survival benefit from early revascularization in elderly patients with cardiogenic shock after acute myocardial infarction: a cohort study. J Invasive Cardiol 2009;21:305-12.
23. Lim HS, Farouque O, Andrianopoulos N, Yan BP, Lim CC, Brennan AL, Reid CM, Freeman M, Charter K, Black A, New G, Ajani AE, Duffy SJ, Clark DJ. Survival of elderly patients undergoing percutaneous coronary intervention for acute myocardial infarction complicated by cardiogenic shock.JACC CardiovascInterv 2009;2:146-52.
24. Shah P, Najafi AH, Panza JA, Cooper HA. Outcomes and quality of life in patients>or=85 years of age with ST-elevation myocardial infarction. Am J Cardiol 2009;103:170-4.
25.Mansencal N, Pillieere R, N'Guetta R, Beauchet A, Lacombe P, Dubourg O. Characteristics and prognosis of coronary revascularization procedure in patients age 80 and older presenting with acute myocardial infarction. Med SciMonit 2010;16:CR15-20.
26.Gasior M, Slonka G, Wilczek K, Gierlotka M, Ruzyllo W, Zembala M, Osadnik T, Dubiel J, Zdrojewski T, Kalarus Z, Polonski L. Comparison of invasive and non-invasive treatment strategies in older patients with acute myocardial infarction complicated by cardiogenic shock (from the Polish Registry of Acute Coronary Syndromes - PL-ACS). Am J Cardiol 2011;107:30-6.
27.Tomassini F, Gagnor A, Migliardi A, Tizzani E, Infantino V, Giolitto S, Rosa Conte M, Antonio Lanza G, Gnavi R, Varbella F. Cardiogenic shock complicating acute myocardial infarction in the elderly: Predictors of long-term survival. Catheter CardiovascInterv 2011.
Figure 1:Search methodology for the selection of publications in the meta-analysis
Figure 2:Forrest plot of the effectiveness of ER on short- (Panel A) and intermediate-term (Panel B) mortality in elderly vs. young patients presenting with AMI-CS.
Figure 3:Sensitivity analyses by way of one-study removal of the treatment effect of ER on short- (Panel A) and intermediate-term (Panel B) mortality in elderly vs. young patients with AMI-CS.
Table 1:Baseline characteristics of the entire patient population and the ER and IMS subgroups of elderly patients with AMI-CS.
Paired StudiesPublications / Entire Cohort / Publications / ER / IMS / p
Mean age / 4 / 80.27 ± 1.31 / 2 / 78.43 ± 1.05 / 78.78 ± 0.74 / 0.71
Male / 8 / 40.87 / 3 / 47.17 / 35.45 / <0.001
HTN / 7 / 53.79 / 3 / 57.42 / 53.91 / 0.15
DM / 8 / 31.99 / 3 / 35.16 / 32.69 / 0.3
Renal Insufficiency / 4 / 16.17 / 2 / 7.08 / 15.05 / 0.2
PVD / 2 / 8.82 / 1 / 0 / 6.25 / 0.5
HLD / 5 / 29.40 / 3 / 32.51 / 28.08 / 0.05
prior CHF / 5 / 24.01 / 1 / 4.17 / 21.88 / 0.12
prior CVA / 2 / 12.54
prior MI / 7 / 30.82 / 3 / 25.97 / 28.91 / 0.19
prior PCI / 5 / 2.42 / 2 / 3.00 / 1.47 / 0.04
prior CABG / 5 / 5.17 / 2 / 6.57 / 3.27 / 0.002
smoker / 5 / 12.97 / 3 / 18.02 / 11.09 / <0.0001