[The use of primary coronary angioplasty in acute myocardial infarction in patients over 70 years of age].
OBJECTIVE
To evaluate the use of primary coronary angioplasty (PTCA) in patients older than 70 years, evolving with acute myocardial infarction, without the previous administration of thrombolytic agents.


METHODS
Forty-two patients with acute myocardial infarction (AMI) and more than 70 years of age (m = 76.4y). There were 54.7% men and 43% of them had anterior MI. PTCA was carried out during the first 12 hours of evolution and in the first 3 hours of duration in 47% of them. PTCA was done only to the AMI related artery, which was the left descending artery in 43%, the right coronary artery in 47% and the left circumflex in the remaining patients. Nineteen percent of these patients were in Killip class III e IV.


RESULTS
Primary success was achieved in 86%. The in hospital mortality was 14.2%, and it was superior in female gender (26.3%), in Killip class III and IV (37.5%), in those with multivessel coronary disease (16.6%) and in those where primary PTCA failed (33%). There were 9.3% of reinfarction, but no major hemorrhages happened. Late angiography was done in 50% of patients, showing 72% of patency in the AMI related artery, and a significant improval of global ejection fraction and of the wall motion, particularly, in those who maintained arterial patency.


CONCLUSIONS
Primary PTCA, without former use of thrombolytic agents, when applied early in elderly patients evolving with AMI, has a high success rate and low mortality rate in this subset of high risk patients. It also shows no major hemorrhagic complications.
Mattos
L A
LA
Instituto Dante Pazzanese de Cardiologia, São Paulo.
Cano
M N
MN
Maldonado
G
G
Feres
F
F
Pinto
I M
IM
Tanajura
L F
LF
Gun
C
C
Fontes
V F
VF
Sousa
A G
AG
Sousa
J E
JE
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D013318:Stroke Volume / Q000502:physiology
Emprego da angioplastia coronária primária no infarto agudo do miocárdio em pacientes acima de 70 anos.