SILVER-AMI: Outcomes in Older Persons With Heart Attacks
- Conditions
- Acute Myocardial Infarction
- Registration Number
- NCT01755052
- Lead Sponsor
- Yale University
- Brief Summary
SILVER-AMI is a research study of older persons who are admitted to the hospital with a heart attack. Patients will be interviewed in the hospital and again 6 months later. The researchers will also collect detailed medical record information to understand the effect of heart attacks on older persons.
The research team at Yale University will use this information to develop a risk model that can be used to help doctors predict recovery. The goal of the study is to help older people in the future make well-informed decisions about their health care during a heart attack.
- Detailed Description
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 older patients, who consistently rate maintenance of favorable health status as a top priority. This study will address these gaps by melding principles from geriatrics and cardiology to create post-AMI risk models specifically designed for older patients. This study is significant because older persons with AMI are a growing, yet understudied, population.
Dr. Sarwat Chaudhry at Yale University is conducting a multi-center, observational study designed to collect data about the post-AMI recovery period that will be used to generate risk models for older patients with AMI. The intent of the study is to use the knowledge from the data collected in SILVER-AMI to ultimately design interventions to improve the care and outcomes of older patients with AMI.
Study coordinators will screen older patients hospitalized with an AMI. Participants will be assessed at baseline prior to AMI hospital discharge through an interview, physical assessment and medical record review. One follow-up interview will be conducted approximately 6 months later by the Yale Follow-up Center. Clinical outcomes will be assessed for the follow-up period occurring 6 months post AMI hospitalization through self-report and medical record review.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 3042
-
Age ≥75 years upon admission to the hospital
-
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.
-
Any one of the following:
- Symptoms of ischemia
- ECG with ischemic changes
- Imaging evidence of Infarction
- Intracoronary thrombus on angiography
- Patient transferred from another hospital with a length of stay >48 hours at the referring hospital.
- Refused Informed Consent
- Decisional impairment with no legally authorized representative
- AMI is secondary to chest trauma
- AMI is secondary to in-patient procedure or surgery
- History of heart transplant
- Non-English/Non-Spanish speaking
- Inability to complete interview (e.g. comatose or aphasia)
- Inability to contact for follow-up (e.g. no access to phone, not living in the country)
- Currently a prisoner
- Death prior to enrollment
- Previously enrolled in SILVER-AMI
- Troponin elevation is the result of apical ballooning syndrome (i.e., Takotsubo)
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method All-cause hospital readmission up to six months
- Secondary Outcome Measures
Name Time Method All-cause mortality Up to six months Decline in health status up to six months
Trial Locations
- Locations (81)
Meritus Medical Center
🇺🇸Hagerstown, Maryland, United States
Mission Medical Associates, Inc. dba Asheville Cardiology Associates
🇺🇸Asheville, North Carolina, United States
Emory University
🇺🇸Atlanta, Georgia, United States
St. Joseph's Medical Center
🇺🇸Stockton, California, United States
Parkview Research Center
🇺🇸Fort Wayne, Indiana, United States
South Georgia Medical Center
🇺🇸Valdosta, Georgia, United States
Santa Barbara Cottage Hospital
🇺🇸Santa Barbara, California, United States
Saint Francis Hospital and Medical Center
🇺🇸Hartford, Connecticut, United States
Sparks Regional Medical Center
🇺🇸Fort Smith, Arkansas, United States
The Corporation of Mercer University
🇺🇸Macon, Georgia, United States
Saint Alphonsus Regional Medical Center
🇺🇸Boise, Idaho, United States
Iowa Heart Center
🇺🇸Des Moines, Iowa, United States
Lankenau Hospital
🇺🇸Wynnewood, Pennsylvania, United States
Spectrum Health Hospitals
🇺🇸Grand Rapids, Michigan, United States
Overlook Medical Center
🇺🇸Summit, New Jersey, United States
Sanford Research
🇺🇸Fargo, North Dakota, United States
Doylestown Hospital
🇺🇸Doylestown, Pennsylvania, United States
Cardiovascular Research Foundation of Louisiana
🇺🇸Baton Rouge, Louisiana, United States
Donald Guthrie Foundation for Education and Research
🇺🇸Sayre, Pennsylvania, United States
Oakwood Hospital and Medical Center
🇺🇸Dearborn, Michigan, United States
Advanced Heart Care, LLC
🇺🇸Bridgewater, New Jersey, United States
The International Heart Institute of Montana
🇺🇸Missoula, Montana, United States
Metropolitan Cardiology Consultants
🇺🇸Coon Rapids, Minnesota, United States
St. Francis Research & Educational Corporation
🇺🇸Roslyn, New York, United States
Good Samaritan Hospital, Corvallis
🇺🇸Corvallis, Oregon, United States
Stroobants Cardiovascular Center
🇺🇸Lynchburg, Virginia, United States
Cox Health
🇺🇸Springfield, Missouri, United States
Nebraska Specialty Network
🇺🇸Lincoln, Nebraska, United States
Munson Medical Center
🇺🇸Traverse City, Michigan, United States
Presbyterian Heart Group
🇺🇸Albuquerque, New Mexico, United States
Providence Healthcare Network
🇺🇸Waco, Texas, United States
The Research Foundation for the State University of New York
🇺🇸Stony Brook, New York, United States
Rapid City Regional Hospital, Inc.
🇺🇸Rapid City, South Dakota, United States
Washington University
🇺🇸Saint Louis, Missouri, United States
Hackensack University Medical Center
🇺🇸Hackensack, New Jersey, United States
University of Pittsburgh Medical Center
🇺🇸Pittsburgh, Pennsylvania, United States
Montefiore/Albert Einstein Medical Center
🇺🇸Bronx, New York, United States
Brigham and Women's Hospital, Inc.
🇺🇸Boston, Massachusetts, United States
Beth Israel Deaconess Medical Center
🇺🇸Boston, Massachusetts, United States
St. Francis Medical Group
🇺🇸Indianapolis, Indiana, United States
Minneapolis Heart Institute Foundation
🇺🇸Minneapolis, Minnesota, United States
Los Alamitos Internal Medical Group
🇺🇸Los Alamitos, California, United States
Torrance Memorial Medical Center
🇺🇸Torrance, California, United States
The Danbury Hospital and the Western Connecticut Medical
🇺🇸Danbury, Connecticut, United States
The Queen's Medical Center
🇺🇸Honolulu, Hawaii, United States
The University Of Chicago
🇺🇸Chicago, Illinois, United States
Rush University Medical Center
🇺🇸Chicago, Illinois, United States
Northshore University Health System
🇺🇸Evanston, Illinois, United States
University of Iowa Hospitals and Clinics
🇺🇸Iowa City, Iowa, United States
UMass Memorial Medical Center
🇺🇸Worcester, Massachusetts, United States
Sentara Hospital
🇺🇸Norfolk, Virginia, United States
McLaren Cardiovascular Group
🇺🇸Okemos, Michigan, United States
St Mary's Medical Center
🇺🇸Huntington, West Virginia, United States
Bellin Memorial Hospital, Inc.
🇺🇸Green Bay, Wisconsin, United States
New York University School of Medicine
🇺🇸New York, New York, United States
The Trustees of Columbia University in the City of New York
🇺🇸New York, New York, United States
Denver Health Medical Center
🇺🇸Denver, Colorado, United States
St. John Hospital & Medical Center
🇺🇸Detroit, Michigan, United States
OHSU: Oregon Health & Science University
🇺🇸Portland, Oregon, United States
Oklahoma Heart Hospital Research Foundation
🇺🇸Oklahoma City, Oklahoma, United States
Providence Health & Services
🇺🇸Portland, Oregon, United States
Portland VA Medical Center
🇺🇸Portland, Oregon, United States
Boston Medical Center
🇺🇸Boston, Massachusetts, United States
Englewood Hospital and Medical Center
🇺🇸Englewood, New Jersey, United States
Northwestern Memorial Hospital
🇺🇸Chicago, Illinois, United States
Bridgeport Hospital
🇺🇸Bridgeport, Connecticut, United States
Mercy General Hospital
🇺🇸Sacramento, California, United States
University of Colorado
🇺🇸Aurora, Colorado, United States
Yale University
🇺🇸New Haven, Connecticut, United States
Florida Hospital Pepin Heart Institute
🇺🇸Tampa, Florida, United States
Mid America Heart Institute St. Luke's Hospital
🇺🇸Kansas City, Missouri, United States
University of Michigan Health Systems
🇺🇸Ann Arbor, Michigan, United States
Mayo Clinic
🇺🇸Rochester, Minnesota, United States
University of North Carolina at Chapel Hill
🇺🇸Chapel Hill, North Carolina, United States
CHI-Health-Alegent Creighton Research
🇺🇸Omaha, Nebraska, United States
Forsyth Medical Center
🇺🇸Winston-Salem, North Carolina, United States
Wake Forest University Health Sciences
🇺🇸Winston-Salem, North Carolina, United States
Aurora Research Institute
🇺🇸Milwaukee, Wisconsin, United States
Virginia Commonwealth University
🇺🇸Richmond, Virginia, United States
Thomas Jefferson University
🇺🇸Philadelphia, Pennsylvania, United States
Rhode Island Hospital
🇺🇸Providence, Rhode Island, United States