[The effect of age on the clinical outcomes of patients with acute myocardial infarction treated by direct percutaneous coronary intervention].
OBJECTIVE
To investigate the effect of old age on the clinical outcomes of patients with ST-segment elevation acute myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (PCI).


METHODS
156 consecutive patients with STEMI treated by primary PCI were divided into two groups according to the age of patients: (1) >or= 75 years group (35 cases), with a mean (79.6 +/- 4.1) years; (2) < 75 years group (121 cases), with a mean (60.5 +/- 8.7) years. The baseline clinical characteristics and coronary artery lesions were analyzed and major cardiovascular events (MACE) were followed-up during a period of 1 - 12 months.


RESULTS
There were higher proportion of stroke, longer duration of onset of symptom to balloon and lower left ventricular ejection fraction (LVEF) in patients >or= 75 years than in those < 75 years (all P < 0.05). Coronary angiogram indicated there was lower percentage of patients with single vessel disease, but higher percentage of patients with multivessel disease in >or= 75 years group than in < 75 years group (all P < 0.05). One hundred and forty five patients (32 cases >or= 75 years and 113 cases < 75 years) were followed-up. No significant difference in rate of non-fatal reinfarction was found between the 2 groups, but the hospital cardiac mortality was higher in patients >or= 75 years than in those < 75 years (9.4% vs 1.8%, P < 0.05). During a mean of (7.3 +/- 3.2) months follow-up, the total cardiac mortality rate increased significantly in >or= 75 years group than in < 75 years group (12.5% vs 1.8%, P < 0.05). Multivariate logistic regression analysis showed that age >or= 75 years and decrease in LVEF were associated with increased cardiac mortality in patients with STEMI referred to primary PCI.


CONCLUSIONS
Age >or= 75 years was an independent predictor for increase in cardiac mortality in patients with STEMI treated by primary PCI.
Zhao
Mingzhong
M
Department of Cardiology, People's Hospital, Peking University, Beijing 100044, China.
Hu
Dayi
D
Ma
Zhimin
Z
Xu
Yuyun
Y
Sun
Shuhong
S
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000628:therapy*; D016896:Treatment Outcome