title: Percutaneous coronary intervention for acute myocardial infarction in elderly patients with renal dysfunction: results from the Korea Acute Myocardial Infarction Registry.
abstract: This study aimed to evaluate the effects of percutaneous coronary intervention (PCI) on short- and long-term major adverse cardiac events (MACE) in elderly (>75 yr old) acute myocardial infarction (AMI) patients with renal dysfunction. As part of Korea AMI Registry (KAMIR), elderly patients with AMI and renal dysfunction (GFR<60 mL/min) received either medical (n=439) or PCI (n=1,019) therapy. Primary end point was in-hospital death. Secondary end point was MACE during a 1 month and 1 yr follow-up. PCI group showed a significantly lower incidence of in-hospital death (20.0% vs 14.3%, P=0.006). Short-term and long-term MACE rates were higher in medical therapy group (31.9% vs 19.0%; 57.7% vs 31.3%, P<0.001), and this difference was mainly attributed to cardiac death (29.3% vs 17.6%; 51.9% vs 25.0%, P<0.001). MACE-free survival time after adjustment was also higher in PCI group on short-term (hazard ratio, 0.67; confidence interval, 0.45-0.98; P=0.037) and long-term follow-up (hazard ratio, 0.61, confidence interval, 0.45-0.83; P=0.002). In elderly AMI patients with renal dysfunction, PCI therapy yields favorable in-hospital and short-term and long-term MACE-free survival.
authors.affiliation: Department of Internal Medicine, Korea University, Ansan, Korea.
authors.forename: Sang Yup
authors.initials: SY
authors.lastname: Lim
authors.forename: Eun Hui
authors.initials: EH
authors.lastname: Bae
authors.forename: Joon Seok
authors.initials: JS
authors.lastname: Choi
authors.forename: Chang Seong
authors.initials: CS
authors.lastname: Kim
authors.forename: Seong Kwon
authors.initials: SK
authors.lastname: Ma
authors.forename: Youngkeun
authors.initials: Y
authors.lastname: Ahn
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Weon
authors.initials: W
authors.lastname: Kim
authors.forename: Jong Shin
authors.initials: JS
authors.lastname: Woo
authors.forename: Young Jo
authors.initials: YJ
authors.lastname: Kim
authors.forename: Myeong Chan
authors.initials: MC
authors.lastname: Cho
authors.forename: Chong Jin
authors.initials: CJ
authors.lastname: Kim
authors.forename: Soo Wan
authors.initials: SW
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D012042:Registries; D051437:Renal Insufficiency / Q000150:complications*; D056910:Republic of Korea; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D003404:Creatinine
keywords: Acute Myocardial Infarction; Elderly; Major Adverse Cardiac Event; Percutaneous Coronary Intervention; Renal Dysfunction