Article Data

  • Views 53
  • Dowloads 0

Original Research

Open Access

Effects of a percutaneous coronary intervention or conservative treatment strategy on treatment outcomes in elderly female patients with acute coronary syndrome


1Clinic for heart and cardiovascular diseases, University Hospital of Split, Split, Croatia

2 Dalmatian County Institute of Emergency Medicine, Croatia

3 Department of Maxillofacial Surgery, University Hospital of Split, Split, Croatia

4 Department of Pathophysiology, School of Medicine, University of Split, Split, Croatia

5 Department of Internal Medicine, University Hospital of Split, Split, Croatia

DOI: 10.22514/SV121.102016.16 Vol.12,Issue S1,October 2016 pp.96-100

Published: 10 October 2016

*Corresponding Author(s): DOMAGOJ MARKOVIC E-mail:

PDF (332.31 kB)


Aim. To determine the difference in hospi-tal outcomes between percutaneous coro-nary intervention (PCI) and conservative treatment of elderly female patients hos-pitalized for acute coronary syndrome (ACS).

Material and Methods. This controlled study included 123 female patients admit-ted to the Clinic for heart and cardiovas-cular diseases University Hospital of Split with a diagnosis of ACS and multiple car-diovascular risk factors. We recorded their habits, history, demographics, presenting symptoms, electrocardiograms, ultra-sound results, laboratory tests, diagnostic tests and treatment. We compared these data between the two groups, i.e., those treated with conservative therapy and those treated with PCI.

Results. There were fewer arrhythmias (P<0.001) and episodes of heart failure (P<0.001) during hospitalization in the PCI group than in the conservative ther-apy group. There was no significant differ-ence in complications between the groups (P=0.887).

Conclusion. Elderly female patients with ACS treated with PCI had less arrhythmias and heart failure during hospitalization than those treated with conservative ther-apy and there was no difference in com-plications. These results suggest that even high risk patients have better outcomes af-ter treatment with PCI, and therefore PCI is suggested as first-line treatment in these patients, regardless of risk factors.

Key words

percutaneous coronary interven-tion, acute coronary syndrome, women

Cite And Share

DOMAGOJ MARKOVIC,ANDRO RADANOVIC,ANTE MIHOVILOVIC,JOSKO BOZIC,AJVOR LUKIN,MIROSLAV SIMUNIC. Effects of a percutaneous coronary intervention or conservative treatment strategy on treatment outcomes in elderly female patients with acute coronary syndrome. Signa Vitae. 2016. 12(S1);96-100.


1. Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study. Lancet 1997 May 24; 349(9064):1498–504.

2. untitled – guidelines-nste-acs-ft.pdf [Internet]. [Cited 2014 Jun 26]. Available from:

3. American Heart Association. Heart Disease and Stroke Statistics– 2004 Update. Dallas, TX: American Heart Association, 2003.

4. Ayanian JZ, Epstein AM. Differences in the use of procedures between women and men hospitalized for coronary heart disease. N Engl J Med 1991 Jul 25;325(4):221–5.

5. Healy B. The Yentl syndrome. N Engl J Med 1991 Jul 25;325(4):274–6.

6. Poon S, Goodman SG, Yan RT, Bugiardini R, Bierman AS, Eagle KA, et al. Bridging the gender gap: Insights from a contemporary analysis of sex-related differences in the treatment and outcomes of patients with acute coronary syndromes. Am Heart J 2012 Jan;163(1):66–73.

7. Blomkalns AL, Chen AY, Hochman JS, Peterson ED, Trynosky K, Diercks DB, et al, CRUSADE Investigators. Gender disparities in the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes: large-scale observations from the CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the American College of Cardiology/American Heart Association Guidelines) National Quality Improvement Initiative. J Am Coll Cardiol 2005 Mar 15;45(6):832–7.

8. Radovanovic D, Erne P, Urban P, Bertel O, Rickli H, Gaspoz J-M. Gender differences in management and outcomes in patients with acute coronary syndromes: results on 20 290 patients from the AMIS Plus Registry. Heart 2007 Nov;93(11):1369–75.

9. Jneid H, Fonarow GC, Cannon CP, Hernandez AF, Palacios IF, Maree AO, et al, Get With the Guidelines Steering Committee and In-vestigators. Sex differences in medical care and early death after acute myocardial infarction. Circulation 2008 Dec 16;118(25):2803–10.

10. El-Menyar A, Zubaid M, Sulaiman K, AlMahmeed W, Singh R, Alsheikh-Ali AA, Al Suwaidi J. Atypical presentation of acute coro-nary syndrome: A significant independent predictor of in-hospital mortality. J Cardiol 2011 Mar;57(2):165–71.

11. Xhyheri B, Bugiardini R. Diagnosis and treatment of heart disease: are women different from men? Prog Cardiovasc Dis 2010 Dec;53(3):227–36.

12. Bugiardini R, Bairey Merz CN. Angina with “normal” coronary arteries: a changing philosophy. JAMA J Am Med Assoc 2005 Jan 26;293(4):477–84.

13. Rittger H, Schnupp S, Sinha A-M, Breithardt O-A, Schmidt M, Zimmermann S, et al. Predictors of treatment in acute coronary syn-dromes in the elderly: impact on decision making and clinical outcome after interventional versus conservative treatment. Catheter Cardiovasc Interv Off J Soc Card Angiogr Interv 2012 Nov 1; 80(5):735–43.

14. Wallentin L, Lagerqvist B, Husted S, Kontny F, Ståhle E, Swahn E. Outcome at 1 year after an invasive compared with a non-invasive strategy in unstable coronary-artery disease: the FRISC II invasive randomised trial. FRISC II Investigators. Fast Revascularisation during Instability in Coronary artery disease. Lancet 2000 Jul 1;356(9223):9–16.

15. Lagerqvist B, Husted S, Kontny F, Ståhle E, Swahn E, Wallentin L. 5-year outcomes in the FRISC-II randomised trial of an invasive versus a non-invasive strategy in non-ST-elevation acute coronary syndrome: a follow-up study. Lancet 2006 Sep 22;368(9540):998–1004.

16. Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes – guidelines-NSTE-ACS-FT-2007.pdf [Internet]. [Cited 2014 Jun 26]. Available from:

17. Harlow SD, Gass M, Hall JE, Lobo R, Maki P, Rebar RW, et al, STRAW + 10 Collaborative Group. Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging. J Clin Endocrinol Metab 2012 Apr;97(4):1159–68.

18. Killip III T, Kimball JT. Treatment of myocardial infarction in a coronary care unit: A Two year experience with 250 patients. Am J Cardiol 1967 Oct;20(4):457–64.

19. The Criteria Committee of the New York Heart Association Nomenclature and criteria for diagnosis of diseases of the heart and blood vessels. Boston: Little Brown, 1964.

20. Paraschos A, Callwood D, Wightman MB, Tcheng JE, Phillips HR, Stiles GL, et al. Outcomes following elective percutaneous coro-nary intervention without on-site surgical backup in a community hospital. Am J Cardiol 2005 May 1;95(9):1091–3.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) The Science Citation Index (SCI) is a citation index originally produced by the Institute for Scientific Information (ISI) and created by Eugene Garfield. It (Science Citation Index Expanded) covers more than 8,500 notable and significant journals, across 150 disciplines in science and technology, from 1900 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

IndexCopernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time