Queen's University Belfast

Academic Institute

Bernadette McGuinness

E037

Acute myocardial infarction, commonly known as heart attack, is one of the leading causes of death and is particularly prevalent after 80 years of age (Alexander, Newby,Cannon et al., 2007). Although invasive procedures, such as coronary angiography and percutaneous coronary interventions, expand the life expectancy of people with myocardial infarction; dementia has previously been shown to be associated with lower utilisation of invasive procedures (Cermakova et al., 2017; Chanti-Ketterl, Pathak, Andel, & Mortimer, 2014; Tehrani, Darki, Erande, & Malik, 2013). Therefore, the mortality rates of people with dementia and myocardial infarction are increased compared to people without dementia who receive invasive treatment (Tehrani et al., 2013). Other evidence suggest that dementia does not affect mortality rates in people with myocardial infarction (Kimata et al., 2008). Clinicians face difficult decisions regarding treating myocardial infarction in people with dementia due to lack of evidence, patients’ older age, reduced life expectancy and risk of adverse effects (Cermakova et al., 2017). Other factors affecting the decision of clinicians are existing comorbidities of people with dementia, including hypertension and chronic anticoagulation (Chanti-Ketterl et al., 2014). The present study explores the rates and management of acute myocardial infarction in people with and without dementia, as well as factors associated with clinicians’ decision to treat or not acute myocardial infarction (ie gender, age, years receiving dementia drugs, comorbidities).

The reduced use of invasive procedures for acute myocardial infarction in people with dementia is likely to have a significant effect in the life expectancy of patients. The present study can play an important role in informing clinical practices and policies about the management of acute myocardial infarction in Northern Ireland. This study is part of a larger project on Dementia Analytics funded by Atlantic Philanthropies, the Executive Office, the Department of Health and Queen’s University Belfast, and aims to improve our understanding of dementia in Northern Ireland.

09/04/2019

TRE