1,445 patients at least 75 years of age participated in the research, presented at the most important world cardiology congress and published in the prestigious “New England Journal of Medicine”. Five years of clinical study, 30 centers involved in Italy, Spain and Poland
September 1, 2023 – It’s called FIRE- FunctIonal assessment in Elderly MI patients (i.e. “Revascularization guided by coronary physiology in elderly patients with heart attack”) and is the study promoted byCardiology Operational Unit of the Cona Hospital (Fe), directed by prof. Gabriele Guardigli, who will revolutionize the therapeutic approach to myocardial infarction in elderly people.
Is it right to treat myocardial infarction in older people in the same way as in younger ones? The professionals of the Cardiology Operating Unit of the Cona Hospital asked themselves this, who designed and conducted a clinical study that involved 1,445 patients at least 75 years of age, hospitalized for acute myocardial infarction and multivessel coronary disease. Study lasting a total of 5 years, which involved 30 centers between Italy, Spain and Poland and whose greatest contribution came from public health of Emilia-Romagnagiven that the Maggiore hospital in Bologna and those in Reggio Emilia, Modena (Baggiovara), Rimini and Ravenna were involved.
The data emerging from the research were all in favor of a preventive complete revascularization strategy.
The results of FIRE were presented by Dr. Simone Biscaglia of Cardiology at the S. Anna Hospital in Ferrara on 26 August at ESC 2023 conference in Amsterdamwhich brings together cardiologists from all over the world in a European city every year, and were simultaneously published in the prestigious medical journal “New England Journal of Medicine”.
The context
The Cardiology of the Cona hospital conceived and conducted one randomized clinical trial to fill a “clinical information gap”. Principal investigator was Dr. Simon Biscay of the Cardiology of the S. Anna Hospital in Ferrara who coordinated a group of Italian, Spanish and Polish professionals, enrolling 1,445 patients at least 75 years of age, hospitalized for acute myocardial infarction and multivessel coronary disease.
In fact, although we observe a constant and gradual aging of the population and more and more elderly people are hospitalized with potentially fatal pathologies – such as acute myocardial infarction – there are few studies focused on elderly patients and their optimal treatment. Therefore, in daily clinical practice doctors often found themselves treating elderly and frail patients with information obtained from studies that had enrolled patients 20 years younger. The optimal treatment of patients with acute myocardial infarction is no exception. While it has been shown that treating all the lesions present in the coronary arteries (the 3 small vessels that carry blood and therefore oxygen and nourishment to the heart) of the youngest patient (average age 60-65 years) with myocardial infarction with coronary angioplasty is associated with a better prognosis, it was not known whether the same approach was useful in older patients. Elderly patients are more subject to complications both during angioplasty surgery and during the drug therapy that is necessary after stent implantation. Therefore there was no certain data that extensive treatment, and not limited only to the lesion responsible for the infarction, was as advantageous and protective as for younger patients.
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