Primary percutaneous interventions for acute myocardial infarction in octogenarians: a single-center experience.
BACKGROUND
The majority of cardiovascular deaths occur in the elderly. The safety and results of primary infarct intervention in octogenarians is not well characterized.


OBJECTIVE
The purpose of this study was to compare the results of primary infarct intervention in octogenarians with those in younger patients during 1997-1998 and to compare these results to those obtained in octogenarians treated in 1991-1994.


METHODS
During 1997-1998, 40 octogenarians were treated with primary infarct intervention and were compared with 60 randomly selected patients aged < 80 years treated during the same time period. The results in octogenarians were compared with the results in a group of 37 patients of similar age treated in 1991-1994. The baseline characteristics, procedural results, and hospital outcome were obtained from a prospectively designed interventional database at a busy single-center program.


RESULTS
There was no significant difference in hospital survival between the two groups of patients treated in 1997-1998 although there was a trend toward higher mortality in the octogenarian group. Length of stay and use of intra-aortic balloon pumps were greater in the octogenarian group. When the results in octogenarians treated in 1997-1998 were compared with the group of 37 patients treated in 1991-1994, the hospital mortality declined from 27 to 10% (p = 0.05).


CONCLUSIONS
There has been improvement in hospital mortality over the past decade for patients aged > or = 80 years treated with primary infarct intervention. Hospital resources and length of stay are greater for the octogenarian group. Ongoing research studies are comparing the results of thrombolytic therapy and primary intervention in aged patients.
Skelding
Kimberly A
KA
Department of Internal Medicine, William Beaumont Hospital, Royal Oak, Michigan, USA.
Mehta
Laxmi S
LS
Pica
Mark C
MC
Finta
Bohuslav
B
Shoukfeh
Mazen
M
Grines
Cindy L
CL
O'Neill
William W
WW
Kahn
Joel K
JK
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality / Q000601:surgery*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D013997:Time Factors