Outcome of elderly patients undergoing primary percutaneous coronary intervention for acute ST-elevation myocardial infarction.
OBJECTIVE
To investigate the outcome of primary percutaneous coronary interventions (PCI) in elderly patients (>/=>/=75 years) with ST-elevation myocardial infarction (STEMI).


RESULTS
Between 1995 and 2003, a total of 319 consecutive patients with acute ST-elevation myocardial infarction presenting within 6-12 hr after onset of symptoms were prospectively enrolled in a registry. Of 296 patients undergoing primary PCI, 40 patients were >/=>/=75 years old (group A) and 256 patients younger than 75 years (group B). Elderly patients presented with a lower ejection fraction (49 +/- 14% vs. 53 +/- 13%, P = 0.046) and a higher number of cardiovascular risk factors. PCI success was achieved in 80% (group A) and 91% (group B, P = 0.031), respectively with comparable door-to-balloon times (87 +/- 49 and 95 +/- 79 min, P = ns). Periprocedural complications in both groups were low and major adverse cardiac events (death, myocardial infarction, target vessel revascularization and cardiac rehospitalization) after 6 months amounted to 23% (group A) and 20% (group B, P = ns), respectively.


CONCLUSIONS
Clinical outcome of elderly patients (>/=>/=75 years) with acute STEMI is favorable and comparable with the middle-aged population. However, procedural success was significantly lower in elderly (80%) compared to younger patients (90%). Acute percutaneous coronary intervention appears to be safe and not associated with higher periprocedural complications, in elderly patients.
Wenaweser
Peter
P
Department of Cardiology, University Hospital Bern, Bern, Switzerland.
Ramser
Marianne
M
Windecker
Stephan
S
Lütolf
Indira
I
Meier
Bernhard
B
Seiler
Christian
C
Eberli
Franz R
FR
Hess
Otto M
OM
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006299:Health Services for the Aged; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D016017:Odds Ratio; D011446:Prospective Studies; D012008:Recurrence; D012107:Research Design; D018570:Risk Assessment; D012307:Risk Factors; D013318:Stroke Volume; D011795:Surveys and Questionnaires; D013557:Switzerland; D013997:Time Factors; D016896:Treatment Outcome; D016276:Ventricular Function