SILVER-AMI: Outcomes in Older Persons With Heart Attacks

Launched by YALE UNIVERSITY · Dec 18, 2012

Keywords

ClinConnect Summary

The overall objective of this study is to develop and validate risk stratification tools for older adults who have recently had an Acute Myocardial Infarction (AMI). While there is emerging interest in understanding the role of geriatric conditions as they pertain to cardiovascular outcomes, there is no standard, feasible assessment of older patients with AMI that can stratify their risk of subsequent morbidity and mortality. Currently available risk models are designed solely to predict clinical events (e.g. mortality, reinfarction). This is insufficient for shared decision making with old...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Age ≥75 years upon admission to the hospital
• • 2. Elevation of cardiac markers within 24 hours of presentation to the hospital
• • a. Troponin must rise above the upper limit of normal established by the hospital as a determinate of cardiac injury.
• 3. Any one of the following:
• • 1. Symptoms of ischemia
• • 2. ECG with ischemic changes
• • 3. Imaging evidence of Infarction
• • 4. Intracoronary thrombus on angiography
• Exclusion Criteria:
• • 1. Patient transferred from another hospital with a length of stay \>48 hours at the referring hospital.
• • 2. Refused Informed Consent
• • 3. Decisional impairment with no legally authorized representative
• • 4. AMI is secondary to chest trauma
• • 5. AMI is secondary to in-patient procedure or surgery
• • 6. History of heart transplant
• • 7. Non-English/Non-Spanish speaking
• • 8. Inability to complete interview (e.g. comatose or aphasia)
• • 9. Inability to contact for follow-up (e.g. no access to phone, not living in the country)
• • 10. Currently a prisoner
• • 11. Death prior to enrollment
• • 12. Previously enrolled in SILVER-AMI
• • 13. Troponin elevation is the result of apical ballooning syndrome (i.e., Takotsubo)