title: Prognosis of primary percutaneous coronary intervention in elderly patients with ST-elevation myocardial infarction.
abstract: OBJECTIVE
  To evaluate the prognosis of primary percutaneous coronary intervention (PPCI) and medical therapy (MT) in elderly patients presenting with ST-elevation myocardial infarction (STEMI).
  
  
  METHODS
  A total of 238 STEMI patients aged above 80 and treated with PPCI (n = 186) and MT (n = 52) at Harefield Hospital, London were included in this study. Patients who did not have true STEMI based on non-diagnostic electrocardiogram (ECG) for STEMI and negative troponin, who presented with left bundle branch block (LBBB) and had normal coronaries were excluded from this study. Primary PCI was defined as any use of a guidewire for more than diagnostic purposes in patients with STEMI, whereas conventional MT was defined as treatment of patients with anti-platelets and anti-thrombotic medications without thrombolysis.
  
  
  RESULTS
  The survival rate of PPCI patients was 86% (n = 160) at month 1 followed by 83.9% (n = 156) at month 6, and 81.2% (n = 151) at month 12. The survival rate of MT patients was 44.2% (n = 23) at month 1 followed by 36.5% (n = 19) at month 6, and 34.6% (n = 18) at month 12. Compared to MT, significantly fewer comorbidities were found in the PPCI group. Ventricular fibrillation (VF) (4.8%) and consequent admission to intensive care unit (7%) were the major complications of the PPCI group.
  
  
  CONCLUSIONS
  PPCI has a higher survival rate and, compared to MT, fewer comorbidities were observed in the PPCI group of elderly patients presenting with STEMI.
authors: Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia ; Department of Cardiology, Harefield Hospital, London, United Kingdom.
authors: Abdullah
authors: A
authors: Alkhushail
authors: Department of Cardiology, Harefield Hospital, London, United Kingdom.
authors: Sanjay
authors: S
authors: Kohli
authors: Department of Cardiology, Harefield Hospital, London, United Kingdom.
authors: Andrew
authors: A
authors: Mitchel
authors: Department of Cardiology, Harefield Hospital, London, United Kingdom.
authors: Robert
authors: R
authors: Smith
authors: Department of Cardiology, Harefield Hospital, London, United Kingdom.
authors: Charles
authors: C
authors: Ilsely
keywords: Coronary intervention; Myocardial infarction; Survival rate