title: Trends in mortality rates in elderly ST elevation myocardial infarction patients submitted to primary percutaneous coronary intervention: a 7-year single-center experience.
abstract: OBJECTIVE
  Limited data are available on the safety and outcome of percutaneous coronary intervention (PCI) in elderly patients with ST elevation myocardial infarction (STEMI), as elderly patients are under-represented in randomized trials.
  
  
  METHODS
  We therefore aimed at assessing the trends in mortality rates (both at short-term and at 1-year follow up) in an unselected cohort of 404 STEMI patients aged ≥ 75 years all submitted to primary PCI and consecutively admitted to our Intensive Cardiac Care Unit from 2004 to 2010.
  
  
  RESULTS
  In the first period (2004-2006), 202 patients (202/661, 30.6%) were aged ≥ 75 years, whereas in the second period (2007-2010), 203 patients (203/607, 33.4%) were aged ≥ 75 years. In the second period, STEMI patients were older (P<0.001), more diabetic (P<0.001) and with a higher incidence of comorbidities (P<0.001). A significantly lower use of intra-aortic balloon pump was observed, together with a reduced rate of bleeding, whereas the incidence of worsening renal function significantly increased (P=0.011). No difference was observed in the length of stay and in mortality rate (both in-hospital and 1-year post-discharge) between the first and the second period.
  
  
  CONCLUSIONS
  According to our data, patients aged ≥ 75 years are characterized by an increasing number of comorbidities (in particular, a higher incidence of diabetes). Over a 6-year period, despite a more advanced age, early mortality (and length of stay) remained unchanged (probably thanks to a significant reduction in bleeding events), and no difference was observed in 1-year post-discharge mortality in these patients.
authors.affiliation: Intensive Cardiac Coronary Unit, Heart and Vessel Department, Teaching Hospital Careggi, Florence, Italy. lazzeric@libero.it
authors.forename: Chiara
authors.initials: C
authors.lastname: Lazzeri
authors.forename: Serafina
authors.initials: S
authors.lastname: Valente
authors.forename: Marco
authors.initials: M
authors.lastname: Chiostri
authors.forename: Paola
authors.initials: P
authors.lastname: Attanà
authors.forename: Claudio
authors.initials: C
authors.lastname: Picariello
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Gensini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery; D062645:Percutaneous Coronary Intervention; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome
keywords: ST elevation myocardial infarction; elderly; long-term follow up; percutaneous coronary intervention; prognosis