title: [A case review: About a STEMI in the very elderly].
abstract: Because of the demographic growth of our societies and the increasing prevalence of coronary artery disease with age, we will be increasingly faced with the treatment of myocardial ST+ very elderly patients (>90 years?). If evidence-based medicine does not exist within this framework, there are many registries that can guide us in their care. First, age should not in itself be an indication against reperfusion conventional techniques. In fact recommendations put no upper age limit. The primary angioplasty technical success, which is identical to the younger populations, is the treatment of choice and should be performed preferably by radial arterial access. The thrombolytic alternative, validated for octogenarians, has not been studied for older. Bleeding, neurological, ischemic complications and hospital mortality are more common than in younger populations, especially as the initial hemodynamic alteration is important, but the survivors have the same life-threatening or even better than that of a same reference population ages. Which in itself even justifies maximum adhesion to the therapeutic recommendations taking into account the co-morbidities and possible visceral shortcomings.
authors.affiliation: Pôle cardiovasculaire Antony-Melun, hôpital privé d'Antony, 1, rue Velpeau, 92160 Antony, France; Clinique les Fontaines, 54, boulevard Aristide-Briand, 77000 Melun, France. Electronic address: dupouypatrick@gmail.com.
authors.forename: P
authors.initials: P
authors.lastname: Dupouy
authors.affiliation: Pôle cardiovasculaire Antony-Melun, hôpital privé d'Antony, 1, rue Velpeau, 92160 Antony, France; Clinique les Fontaines, 54, boulevard Aristide-Briand, 77000 Melun, France.
authors.forename: D
authors.initials: D
authors.lastname: Pongas
authors.affiliation: Pôle cardiovasculaire Antony-Melun, hôpital privé d'Antony, 1, rue Velpeau, 92160 Antony, France; Clinique les Fontaines, 54, boulevard Aristide-Briand, 77000 Melun, France.
authors.forename: V
authors.initials: V
authors.lastname: Rubimbura
authors.affiliation: Pôle cardiovasculaire Antony-Melun, hôpital privé d'Antony, 1, rue Velpeau, 92160 Antony, France.
authors.forename: R
authors.initials: R
authors.lastname: Labbe
authors.affiliation: Pôle cardiovasculaire Antony-Melun, hôpital privé d'Antony, 1, rue Velpeau, 92160 Antony, France.
authors.forename: I
authors.initials: I
authors.lastname: Sotirov
authors.affiliation: Pôle cardiovasculaire Antony-Melun, hôpital privé d'Antony, 1, rue Velpeau, 92160 Antony, France; Clinique les Fontaines, 54, boulevard Aristide-Briand, 77000 Melun, France.
authors.forename: J M
authors.initials: JM
authors.lastname: Pernes
mesh_terms: D000369:Aged, 80 and over; D000375:Aging; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D000925:Anticoagulants / Q000008:administration & dosage*; D000077144:Clopidogrel; D004359:Drug Therapy, Combination; D005260:Female; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis / Q000628:therapy*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D006493:Heparin; D000077144:Clopidogrel; D013988:Ticlopidine
keywords: Acute coronary syndrome; Angioplastie primaire; Elderly; Infarctus; Myocardial infarction; Nonagénaires; Patients âgés; Primary angioplasty; Syndrome coronaire aigu; Thrombolyse; Thrombolysis