title: Comparison of early and late clinical outcomes in patients >= 80 versus <80 years of age after successful primary angioplasty for ST segment elevation myocardial infarction.
abstract: OBJECTIVE
  We aimed to compare the efficacy of primary percutaneous coronary intervention (p-PCI) in patients >=80 versus <80 years of age with ST-segment elevation myocardial infarction (STEMI).
  
  
  METHODS
  We retrospectively enrolled 2213 patients with acute STEMI. The patients were prospectively followed up for a median of 42 months. Early and late clinical outcomes were compared according to age.
  
  
  RESULTS
  One-hundred and seventy-nine (8.1%) of the 2213 patients were aged >=80 years. Post-procedural TIMI grade 3 flow was significantly less frequent in the age >=80 years patients (82.1% vs. 91.1%, p<0.001). Rates of mortality (14.5% vs. 3.4%, p<0.001), heart failure (20.7% vs. 10.5%, p<0.001), major hemorrhage (9.5% vs. 3.3%, p<0.001), secondary VT/VF (10.1% vs. 4.2%, p=0.002) and atrial fibrillation (12.8% vs. 4.3%, p<0.001) during the early hospitalization period were significantly higher in the age >=80 years patient group. Overall rates of mortality (40% vs. 9.7%, p<0.001) and total stroke (5.6% vs. 1.1%, p=0.005) at long-term follow-up were also higher in the age >=80 years patient group. However, there was no difference between the two groups with respect to the reinfarction/revascularization rates. Analysis, using the Cox proportional hazards model, revealed that age >=80 to was an independent predictor of long-term mortality (hazard ratio 2.17, 95% CI 1.23-4.17, p=0.02).
  
  
  CONCLUSIONS
  Age is an independent predictor of mortality after p-PCI for STEMI. Although it seems to improve early outcomes, the efficacy of p-PCI at long-term follow-up is limited in elderly patients.
authors.affiliation: Department of Cardiology, Medical Park Fatih Hospital, İstanbul, Turkey.
authors.forename: Vecih
authors.initials: V
authors.lastname: Oduncu
authors.forename: Ayhan
authors.initials: A
authors.lastname: Erkol
authors.forename: Ali Cevat
authors.initials: AC
authors.lastname: Tanalp
authors.forename: Cevat
authors.initials: C
authors.lastname: Kırma
authors.forename: Mustafa
authors.initials: M
authors.lastname: Bulut
authors.forename: Atila
authors.initials: A
authors.lastname: Bitigen
authors.forename: Selçuk
authors.initials: S
authors.lastname: Pala
authors.forename: Kürşat
authors.initials: K
authors.lastname: Tigen
authors.forename: Ali M
authors.initials: AM
authors.lastname: Esen
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D004562:Electrocardiography; D005260:Female; D006299:Health Services for the Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016019:Survival Analysis; D016896:Treatment Outcome