Transfer for primary angioplasty in elderly patients with acute myocardial infarction.
BACKGROUND
The aim of this study was the evaluation of an immediate transfer for primary angioplasty (PPCI) in elderly (age > or = 75 years) patients with ST elevation acute myocardial infarction (STEMI).


METHODS
All elderly patients with STEMI admitted for PPCI from June 2002 to October 2005, were enrolled. Major Adverse Cardiac Events (MACE) were collected at 6 months.


RESULTS
133 patients (group 1) were admitted directly and 154 patients (group 2) were transferred from peripheral hospitals. Ischemia time was 248 +/- 146 min in group 1 and 276 +/- 169 min in group two (P<0.001); door-to-balloon time was 60+/-30 min in group 1 and 90+/-45 min in group two (P<0.0001). At 6 months cardiac death occurred in 15 (11%) and 16 (10%) patients in group 1 and 2 respectively (P=NS), MI in 3(2%) and 2(1%) respectively (P=NS), clinically driven target lesion revascularization in 6(4%) and 5(3%) respectively, for an overall event-free survival rate of 82% in group 1 and 83% in group 2 (P=NS). Logistic regression analysis showed age (OR: 1.04.1; 95% CI: 1.0-1.2; P=0.049) Killip class > or = 2 (OR: 4.6; 95% CI: 1.3-16.4; P=0.01) to be the only independent predictors of 6-month cardiac mortality.


CONCLUSIONS
Systematic transfer of elderly STEMI patients for PPCI, with a door-to-balloon time <1 h, leads to clinical results similar to those achievable in patients who present directly in hospital with cath.-lab. facilities.
Liistro
Francesco
F
Department of Cardiovascular Disease, San Donato Hospital, Arezzo, Italy. francescoliistro@hotmail.com
Angioli
Paolo
P
Ducci
Kenneth
K
Falsini
Giovanni
G
Baldassarre
Silvia
S
Brandini
Rossella
R
Bolognese
Leonardo
L
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009203:Myocardial Infarction / Q000628:therapy*; D010360:Patient Transfer; D016896:Treatment Outcome