title: Reperfusion strategy for acute myocardial infarction in elderly patients aged 75 to 80 years.
abstract: The increasing elderly population will influence the treatment policies adopted in cases of acute myocardial infarction. Considering reperfusion therapy in elderly patients with acute myocardial infarction, we compared three strategies, as follows: primary percutaneous coronary intervention (primary PCI: n = 26), facilitated PCI with half the standard dose of mutant tissue-type plasminogen activator (t-PA) (half + PCI: n = 24), and facilitated PCI with a standard dose of mutant t-PA (standard + PCI: n = 15) between patients 75 and 80 years of age. The rate of acquisition of thrombolysis in myocardial infarction (TIMI-3) flow on initial coronary arteriography was significantly lower in the primary PCI group than in the other two groups (7.7% in the primary PCI group vs 60% in the half + PCI and 66.7% in the standard + PCI group). The incidence of hemorrhagic complications including blood transfusion was not significantly different between primary PCI and facilitated PCI. Considering reperfusion therapy in elderly patients with acute myocardial infarction, we concluded that facilitated PCI may be effective in elderly patients aged 75-80 years.
authors.affiliation: Division of Cardiovascular Medicine, Surugadai Nihon University Hospital, 1-8-13 Kandasurugadai, Tokyo 101-0062, Japan. ikuwata@med.nihon-u.ac.jp
authors.forename: Ikuyoshi
authors.initials: I
authors.lastname: Watanabe
authors.forename: Ken
authors.initials: K
authors.lastname: Nagao
authors.forename: Shigemasa
authors.initials: S
authors.lastname: Tani
authors.forename: Naoki
authors.initials: N
authors.lastname: Masuda
authors.forename: Takaharu
authors.initials: T
authors.lastname: Yahata
authors.forename: Sumito
authors.initials: S
authors.lastname: Ohguchi
authors.forename: Katsuo
authors.initials: K
authors.lastname: Kanmatsuse
authors.forename: Toshio
authors.initials: T
authors.lastname: Kushiro
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy / Q000601:surgery*; D015425:Myocardial Reperfusion / Q000379:methods*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
chemical_list: D010959:Tissue Plasminogen Activator