title: Temporal trends and in-hospital outcomes of primary percutaneous coronary intervention in nonagenarians with ST-segment elevation myocardial infarction.
abstract: OBJECTIVE
  Data regarding the outcomes of primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) in nonagenarians are very limited. The aim of the present study was to evaluate the temporal trends and in-hospital outcomes of primary PCI in nonagenarian STEMI patients.
  
  
  METHODS
  We retrospectively reviewed data from the Korea Acute Myocardial Infarction Registry (KAMIR) from November 2005 to January 2008, and from the Korea Working Group on Myocardial Infarction (KorMI) from February 2008 to May 2010.
  
  
  RESULTS
  During this period, the proportion of nonagenarians among STEMI patients more than doubled (0.59% in KAMIR vs. 1.35% in KorMI), and the rate of use of primary PCI also increased (from 62.5% in KAMIR to 81.0% in KorMI). We identified 84 eligible study patients for which the overall in-hospital mortality rate was 21.4% (25.0% in KAMIR vs. 20.3% in KorMI, p = 0.919). Multivariate analysis identified two independent predictors of in-hospital mortality, namely a final Thrombolysis in Myocardial Infarction (TIMI) flow < 3 (odds ratio [OR], 13.7; 95% confidence interval [CI], 3.2 to 59.0; p < 0.001) and cardiogenic shock during hospitalization (OR, 6.7; 95% CI, 1.5 to 30.3; p = 0.013).
  
  
  CONCLUSIONS
  The number of nonagenarian STEMI patients who have undergone primary PCI has increased. Although a final TIMI flow < 3 and cardiogenic shock are independent predictors of in-hospital mortality, primary PCI can be performed with a high success rate and an acceptable in-hospital mortality rate.
authors.affiliation: Department of Cardiovascular Medicine, Yeocheon Chonnam Hospital, Yeosu, Korea.
authors.forename: Joon Young
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.affiliation: Department of Cardiovascular Medicine, Yeocheon Chonnam Hospital, Yeosu, Korea.
authors.forename: Yong Woo
authors.initials: YW
authors.lastname: Choi
authors.affiliation: Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Yong Keun
authors.initials: YK
authors.lastname: Ahn
authors.affiliation: Department of Cardiovascular Medicine, Kyungpook National University Hospital, Daegu, Korea.
authors.forename: Shung Chull
authors.initials: SC
authors.lastname: Chae
authors.affiliation: Department of Cardiovascular Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.
authors.forename: Seung Ho
authors.initials: SH
authors.lastname: Hur
authors.affiliation: Department of Cardiovascular Medicine, Pusan National University Hospital, Busan, Korea.
authors.forename: Taek Jong
authors.initials: TJ
authors.lastname: Hong
authors.affiliation: Department of Cardiovascular Medicine, Yeungnam University Medical Center, Daegu, Korea.
authors.forename: Young Jo
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Department of Cardiovascular Medicine, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: In Whan
authors.initials: IW
authors.lastname: Seong
authors.affiliation: Department of Cardiovascular Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: In Ho
authors.initials: IH
authors.lastname: Chae
authors.affiliation: Department of Cardiovascular Medicine, Chungbuk National University Hospital, Cheongju, Korea.
authors.forename: Myeong Chan
authors.initials: MC
authors.lastname: Cho
authors.affiliation: Department of Cardiovascular Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Jung Han
authors.initials: JH
authors.lastname: Yoon
authors.affiliation: Department of Cardiovascular Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors.forename: Ki Bae
authors.initials: KB
authors.lastname: Seung
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000401:mortality / Q000639:trends*; D012042:Registries; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D012770:Shock, Cardiogenic / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome
keywords: Aged, 90 and over; In-hospital outcomes; Myocardial infarction; Percutaneous coronary intervention