title: Primary percutaneous coronary intervention for ST elevation myocardial infarction in nonagenarians.
abstract: To assess outcomes following primary percutaneous coronary intervention (PCI) for ST-segment elevation acute myocardial infarction (STEMI) in nonagenarian patients.
  
  
  
  We conducted a multicentre retrospective study between 2006 and 2013 in five international high-volume centres and included consecutive all-comer nonagenarians treated with primary PCI for STEMI. There were no exclusion criteria. We enrolled 145 patients and collected demographic, clinical and procedural data. Severe clinical events and mortality at 6 months and 1 year were assessed.
  
  
  
  Cardiogenic shock was present at admission in 21%. Median (IQR) delay between symptom onset and balloon was 3.7 (2.4-5.6) hours and 60% of procedures were performed through the transradial approach. Successful revascularisation of the culprit vessel was obtained in 86% of the cases (thrombolysis in myocardial infarction flow of 2 or 3). Major or clinically relevant bleeding was observed in 4% of patients. Median left ventricular ejection fraction post PCI was 41.5% (32.0-50.0). The in-hospital mortality was 24%, with 6 months and 1-year survival rates of 61% and 53%, respectively.
  
  
  
  In our study, primary PCI in nonagenarians with STEMI was achieved and feasible through a transradial approach. It is associated with a high rate of reperfusion of the infarct-related artery and 53% survival at 1 year. These results suggest that primary PCI may be offered in selected nonagenarians with acute myocardial infarction.
authors.affiliation: Cardiology Institute, Pitié-Salpêtrière Hospital, UPMC, APHP, Paris, France.
authors.forename: Thibaut
authors.initials: T
authors.lastname: Petroni
authors.affiliation: Freeman Hospital and Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, UK.
authors.forename: Azfar
authors.initials: A
authors.lastname: Zaman
authors.affiliation: Centre Hospitalier de Versailles, André Mignot Hospital, Le Chesnay, France.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Georges
authors.affiliation: Cardiology Institute, Pitié-Salpêtrière Hospital, UPMC, APHP, Paris, France.
authors.forename: Nadjib
authors.initials: N
authors.lastname: Hammoudi
authors.affiliation: Cardiology Institute, Pitié-Salpêtrière Hospital, UPMC, APHP, Paris, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Berman
authors.affiliation: Heart Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israël.
authors.forename: Amit
authors.initials: A
authors.lastname: Segev
authors.affiliation: Bichat Hospital, APHP, Paris, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Juliard
authors.affiliation: Cardiology Institute, Pitié-Salpêtrière Hospital, UPMC, APHP, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Barthelemy
authors.affiliation: Cardiology Institute, Pitié-Salpêtrière Hospital, UPMC, APHP, Paris, France.
authors.forename: Johanne
authors.initials: J
authors.lastname: Silvain
authors.affiliation: Cardiology Institute, Pitié-Salpêtrière Hospital, UPMC, APHP, Paris, France.
authors.forename: Rémi
authors.initials: R
authors.lastname: Choussat
authors.affiliation: Cardiology Institute, Pitié-Salpêtrière Hospital, UPMC, APHP, Paris, France.
authors.forename: Claude
authors.initials: C
authors.lastname: Le Feuvre
authors.affiliation: Cardiology Institute, Pitié-Salpêtrière Hospital, UPMC, APHP, Paris, France.
authors.forename: Gérard
authors.initials: G
authors.lastname: Helft
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D017023:Coronary Angiography; D005060:Europe; D005240:Feasibility Studies; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D017052:Hospital Mortality; D061847:Hospitals, High-Volume; D006801:Humans; D007557:Israel; D053208:Kaplan-Meier Estimate; D008297:Male; D016016:Proportional Hazards Models; D011677:Punctures; D017534:Radial Artery / Q000000981:diagnostic imaging; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D013318:Stroke Volume; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome; D016277:Ventricular Function, Left