Coronary intervention in patients ≥75 years old with ST-elevation myocardial infarction: in-hospital and 6-month clinical outcomes

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Author:
ZHENG Xin(Department of Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China)
XU Bo(Department of Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China)
GAO Run-lin(Department of Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China)
LI Jian-jun(Department of Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China)
YUAN Jin-qing(Department of Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China)
QIN Xue-wen(Department of Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China)
ZHU Cheng-gang(Department of Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China)
GUO Yuan-lin(Department of Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China)
MU Chao-wei(Department of Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China)
HUA Yi-hong(Department of Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China)
YANG Yue-jin(Department of Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China)
Journal Title:
CHINESE MEDICAL JOURNAL
Issue:
Volume 123, Issue 16, 2010
DOI:
10.3760/cma.j.issn.0366-6999.2010.16.002
Key Word:
percutaneous coronary intervention;elderly;myocardial infarction

Abstract: Background ST-segment elevation myocardial infarction (STEMI) in elderly patients presents specific clinical characteristics.The study on percutaneous coronary intervention (PCI) in elderly patients (≥75 years) with STEMI,however, has less been performed.Methods In the present study, 522 consecutive STEMI patients undergoing PCI within 12 hours from symptom onset were investigated, and clinical characteristics and in-hospital and 6-month outcomes of 66 elderly patients (≥75 years,group A) were compared to those of 456 younger patients (<75 years, group B).Results Compared to younger patients, elderly ones had more females (42.4% vs.17.8%, P <0.005), a history of cerebral vascular events (7.6% vs.0.9%, P <0.05), higher serum creatinine level ((96.48±31.65) mmol/L vs.(84.87±19.81)mmol/L, P<0.005) and fewer smokers (28.8% vs.45.4%, P<0.05).The elderly ones had worse Killip class (Killip I class:69.7% vs.85.7%, P <0.05), less drug-eluting stent implantation and lower rates of TIMI flow 3 following PCI (33.3% vs.47.1%, and 84.8% vs.94.7%, P <0.05 respectively).Additionally, both in-hospital mortality and myocardial infarction rate were found to be higher in elderly patients (16.7% vs.1.5%, and 7.6% vs.2.6%, P <0.05 respectively), which were also observed until 6-month follow-up (9.1% vs.0, and 6.1% vs.0, P <0.05 respectively=.In multivariable Cox regression analysis, serum creatinine level, history of hypertension, left anterior descending coronary artery as infarct-related artery and Killip class were independent predictors of 6-month overall death in elderly patients.Conclusions The clinical characteristics of elderly patients with STEMI after PCI are different from those of younger patients.Although PCI in this population is with a low rate of PCI failure, it is still associated with a worse outcome.

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