title: Comparison of clinical outcomes between octogenarians and non-octogenarians with acute myocardial infarction in the drug-eluting stent era: analysis of the Korean Acute Myocardial Infarction Registry.
abstract: OBJECTIVE
  Octogenarians (age ≥ 80 years) with coronary artery disease constitute a high-risk group. However, octogenarian patients with acute myocardial infarction (AMI) in the drug-eluting stents (DES) era have not been widely reported. We aimed to identify clinical outcomes in octogenarian compared with non-octogenarian AMI patients.
  
  
  METHODS
  We retrospectively analyzed 9877 patients who underwent percutaneous coronary intervention (PCI) with drug-eluting stents (DES) and who were enrolled in the Korean Acute Myocardial Infarction Registry (KAMIR). They were divided into 2 groups, octogenarians (n=1494) and non-octogenarians (n=8383), in order to compare the incidence of 1-year all-cause death and 1-year major adverse cardiac events (MACE), where MACE included all-cause death, recurrent myocardial infarction, target vessel revascularization (TVR), target lesion revascularization (TLR), and coronary artery bypass grafting (CABG).
  
  
  RESULTS
  The clinical status was significantly inferior in octogenarians compared to non-octogenarians: Killip class ≥ II (34.8% vs. 22.5%, p<0.001), multivessel disease (65.8% vs. 53.7%, p<0.001). Rates of 1-year all-cause death were significantly higher in octogenarians than in non-octogenarians (22.3% vs. 6.5%, p<0.001). However, the rates of 1-year recurrent myocardial infarction (1.3% vs. 0.9%, p=0.68), TLR (2.4% vs. 3.1%, p=0.69), TVR (3.6% vs. 4.3%, p=0.96), and CABG (0.9% vs. 0.9%, p=0.76) did not differ significantly between the 2 groups.
  
  
  CONCLUSIONS
  Octogenarian AMI patients have higher rates of mortality and MACE even in the DES era. According to KAMIR subgroup analysis, the TLR/TVR rates in octogenarians were comparable to those in non-octogenarian AMI patients.
authors.affiliation: Chonnam National University Hospital, Gwangju, Republic of Korea; Shonan Kamakura Hospital, Japan.
authors.forename: Futoshi
authors.initials: F
authors.lastname: Yamanaka
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Shigeru
authors.initials: S
authors.lastname: Saito
authors.forename: Youngkeun
authors.initials: Y
authors.lastname: Ahn
authors.forename: Shung Chull
authors.initials: SC
authors.lastname: Chae
authors.forename: Seung Ho
authors.initials: SH
authors.lastname: Hur
authors.forename: Taek Jong
authors.initials: TJ
authors.lastname: Hong
authors.forename: Young Jo
authors.initials: YJ
authors.lastname: Kim
authors.forename: In Whan
authors.initials: IW
authors.lastname: Seong
authors.forename: Jei Keon
authors.initials: JK
authors.lastname: Chae
authors.forename: Jay Young
authors.initials: JY
authors.lastname: Rhew
authors.forename: In Ho
authors.initials: IH
authors.lastname: Chae
authors.forename: Myeong Chan
authors.initials: MC
authors.lastname: Cho
authors.forename: Jang Ho
authors.initials: JH
authors.lastname: Bae
authors.forename: Seung Woon
authors.initials: SW
authors.lastname: Rha
authors.forename: Chong Jin
authors.initials: CJ
authors.lastname: Kim
authors.forename: Donghoon
authors.initials: D
authors.lastname: Choi
authors.forename: Yang Soo
authors.initials: YS
authors.lastname: Jang
authors.forename: Junghan
authors.initials: J
authors.lastname: Yoon
authors.forename: Wook Sung
authors.initials: WS
authors.lastname: Chung
authors.forename: Jeong Gwan
authors.initials: JG
authors.lastname: Cho
authors.forename: Ki Bae
authors.initials: KB
authors.lastname: Seung
authors.forename: Seung Jung
authors.initials: SJ
authors.lastname: Park
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality; D002423:Cause of Death; D001026:Coronary Artery Bypass; D054855:Drug-Eluting Stents; D005260:Female; D006027:Glycosides; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D012008:Recurrence; D012042:Registries; D056910:Republic of Korea; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014315:Triterpenes
chemical_list: D006027:Glycosides; D014315:Triterpenes; C108202:koreoside A
keywords: Elderly; Myocardial infarction; Prognosis; Treatment