title: Predictors of in-hospital mortality in octogenarian patients who underwent primary percutaneous coronary intervention after ST segment elevated myocardial infarction.
abstract: OBJECTIVE
  Octogenarian patients have higher mortality and morbidity rates after acute coronary syndromes. Risk factors for in-hospital mortality in the primary percutaneous coronary intervention (PCI) era were underrepresented in previous studies. In the present study, we aimed to assess the risk factors of in-hospital mortality after primary PCI in this population.
  
  
  METHODS
  We analyzed 2353 patients who underwent primary PCI after ST segment elevated myocardial infarction (STEMI). Patients were divided into two groups according to aged: ≥80 years (octogenarian) and <80 years (control). Risk factors for in-hospital mortality were analyzed in the whole group and octogenarian patients.
  
  
  RESULTS
  We found that octogenarians have 10.6-fold higher mortality risk after STEMI. After a univariate and multivariate analysis, acute stent thrombosis was the most explicit risk factor for in-hospital mortality in the octogenarian group (OR 21.13, 95% CI 2.11-102.76, P < 0.001). Additionally, anterior myocardial infarction (OR 4.90, 95% CI 1.90-22.10, P = 0.04), ventricular arrhythmias (OR 15.64, 95% CI 2.81-87.12, P = 0.002), multivessel disease (OR 6.5, 95% CI 1.11-38.85, P = 0.04), ejection fraction <30% (OR 1.24, 95% CI 0.26-6.00, P = 0.04) and KILLIP score ≥2 (OR 1.20, 95% CI 0.20- 7.41, P = 0.01) were also significantly associated with mortality.
  
  
  CONCLUSIONS
  Acute stent thrombosis, anterior MI, heart failure, low ejection fraction, ventricular arrhythmias and multivessel disease are the independent risk factors for in-hospital mortality among octogenarian patients after primary PCI. Geriatr Gerontol Int 2017; 17: 584-590.
authors.affiliation: Siyami Ersek Cardiothoracic Surgery Center, Department of Cardiology, Istanbul, Turkey.
authors.forename: Gokturk
authors.initials: G
authors.lastname: Ipek
authors.affiliation: Ataturk Training and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Ozge
authors.initials: O
authors.lastname: Kurmus
authors.affiliation: Ataturk Training and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Cemal
authors.initials: C
authors.lastname: Koseoglu
authors.affiliation: Siyami Ersek Cardiothoracic Surgery Center, Department of Cardiology, Istanbul, Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: Onuk
authors.affiliation: Siyami Ersek Cardiothoracic Surgery Center, Department of Cardiology, Istanbul, Turkey.
authors.forename: Baris
authors.initials: B
authors.lastname: Gungor
authors.affiliation: Ataturk Training and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Kirbas
authors.affiliation: Siyami Ersek Cardiothoracic Surgery Center, Department of Cardiology, Istanbul, Turkey.
authors.forename: Mehmet B
authors.initials: MB
authors.lastname: Karatas
authors.affiliation: Siyami Ersek Cardiothoracic Surgery Center, Department of Cardiology, Istanbul, Turkey.
authors.forename: Muhammed
authors.initials: M
authors.lastname: Keskin
authors.affiliation: Siyami Ersek Cardiothoracic Surgery Center, Department of Cardiology, Istanbul, Turkey.
authors.forename: Edibe
authors.initials: E
authors.lastname: Betul Borklu
authors.affiliation: Siyami Ersek Cardiothoracic Surgery Center, Department of Cardiology, Istanbul, Turkey.
authors.forename: Mert Ilker
authors.initials: MI
authors.lastname: Hayiroglu
authors.affiliation: Siyami Ersek Cardiothoracic Surgery Center, Department of Cardiology, Istanbul, Turkey.
authors.forename: Ozan
authors.initials: O
authors.lastname: Tanik
authors.affiliation: Siyami Ersek Cardiothoracic Surgery Center, Department of Cardiology, Istanbul, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Oz
authors.affiliation: Siyami Ersek Cardiothoracic Surgery Center, Department of Cardiology, Istanbul, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Bolca
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*
keywords: In-hospital mortality; ST segment elevated myocardial infarction; octogenarian; primary percutaneous coronary intervention; risk factors