Age and lack of beta-blocker therapy are associated with increased long-term mortality after primary coronary angioplasty for acute myocardial infarction.
BACKGROUND
Few studies have examined the long-term outcome of primary PTCA for acute myocardial infarction, especially in thrombolysis-eligible patients.


METHODS
Retrospective analysis of a consecutive cohort of 228 patients treated with primary angioplasty for ST-segment elevation myocardial infarction, less than 6 h after symptom onset, of whom 203 were discharged alive and had long-term follow-up.


RESULTS
With an average follow-up of 497+/-40 days, actuarial survival rates were 94.4+/-0.02 and 86.8+/-0.06% at 2 and 4 years, respectively. Multivariate analysis showed that lack of beta-blocker therapy at discharge (RR 6.5 and 95% CI: 1.97-21.47) and age (RR 1.09 per year and 95% CI: 1.03-1.16), but not left ventricular ejection fraction were the two independent predictors of late mortality.


CONCLUSIONS
In thrombolysis-eligible patients treated with primary PCI and discharged alive, reinfarction and mortality rates are low. It appears particularly important to enforce prescription of beta-blockers at discharge is an important goal in this population.
Juliard
Jean-Michel
JM
Division of Cardiology, Hôpital Bichat, AP-HP, 46 Rue Henri Huchard, 75877 Cedex 18, Paris, France. jean-michel.juliard@bch.ap-hop-paris.fr
Charlier
Patrick
P
Golmard
Jean-Louis
JL
Himbert
Dominique
D
Aubry
Pierre
P
Benamer
Hakim
H
Feldman
Laurent J
LJ
Karila-Cohen
Daniel
D
Steg
Ph Gabriel
PG
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage* / Q000627:therapeutic use*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D015331:Cohort Studies; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013318:Stroke Volume / Q000187:drug effects / Q000502:physiology; D015996:Survival Rate; D013997:Time Factors
D000319:Adrenergic beta-Antagonists