title: Primary percutaneous coronary intervention in octogenarians.
abstract: BACKGROUND
  Limited data are available on the outcome of primary percutaneous coronary intervention (PCI) in octogenarian patients, as the elderly are under-represented in randomized trials. This study aims to provide insights on clinical characteristics, management and outcome of the elderly and very elderly presenting with STEMI.
  
  
  METHODS
  2225 STEMI patients ≥70years old (mean age 76.8±5.1years and 53.8% men) were admitted into the network of the ISACS-TC registry. Of these patients, 72.8% were ≥70 to 79years old (elderly) and 27.2% were ≥80years old (very-elderly). The primary end-point was 30-day mortality.
  
  
  RESULTS
  Thirty-day mortality rates were 13.4% in the elderly and 23.9% in the very-elderly. Primary PCI decreased the unadjusted risk of death both in the elderly (OR: 0.32, 95% CI: 0.24-0.43) and very-elderly patients (OR: 0.45, 95% CI 0.30-0.68), without significant difference between groups. In the very-elderly hypertension and Killip class ≥2 were the only independent factors associated with mortality; whereas in the elderly female gender, prior stroke, chronic kidney disease and Killip class ≥2 were all factors independently associated with mortality. Factors associated with the lack of use of reperfusion were female gender and atypical chest pain in the very-elderly and in the elderly; in the elderly, however, there were some more factors, namely: history of diabetes, current smoking, prior stroke, Killip class ≥2 and history chronic kidney disease.
  
  
  CONCLUSIONS
  Age is relevant in the prognosis of STEMI, but its importance should not be considered secondary to other major clinical factors. Primary PCI appears to have beneficial effects in the octogenarian STEMI patients.
authors: Department of Experimental, Diagnostic and Specialty Medicine, Section of Cardiology, University of Bologna, Bologna, Italy.
authors: Beatrice
authors: B
authors: Ricci
authors: Department of Experimental, Diagnostic and Specialty Medicine, Section of Cardiology, University of Bologna, Bologna, Italy. Electronic address: olivia.manfrini@unibo.it.
authors: Olivia
authors: O
authors: Manfrini
authors: Department of Experimental, Diagnostic and Specialty Medicine, Section of Cardiology, University of Bologna, Bologna, Italy.
authors: Edina
authors: E
authors: Cenko
authors: Clinical Center of Serbia, Medical Faculty, University of Belgrade, Belgrade, Serbia.
authors: Zorana
authors: Z
authors: Vasiljevic
authors: University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania; Department of Cardiology and Internal Medicine, Floreasca Emergency Hospital, Bucharest, Romania.
authors: Maria
authors: M
authors: Dorobantu
authors: University Clinic of Cardiology, Medical Faculty, University "Ss. Cyril and Methodius", Skopje, Macedonia.
authors: Sasko
authors: S
authors: Kedev
authors: Clinic for Cardiology, Clinical Center Kragujevac, Kragujevac Faculty of Medical Sciences, University in Kragujevac, Kragujevac, Serbia.
authors: Goran
authors: G
authors: Davidovic
authors: University Clinical Hospital Center Bezanijska Kosa, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors: Marija
authors: M
authors: Zdravkovic
authors: Department of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors: Olivija
authors: O
authors: Gustiene
authors: Clinical Center of Montenegro, Center of Cardiology, Podgorica, Montenegro.
authors: Božidarka
authors: B
authors: Knežević
authors: Department for Cardiovascular Diseases, University Hospital Center Zagreb, University of Zagreb, Zagreb, Croatia.
authors: Davor
authors: D
authors: Miličić
authors: Cardiovascular Research Center, CSIC-ICCC, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain.
authors: Lina
authors: L
authors: Badimon
authors: Department of Experimental, Diagnostic and Specialty Medicine, Section of Cardiology, University of Bologna, Bologna, Italy.
authors: Raffaele
authors: R
authors: Bugiardini
mesh_terms: D054058:Acute Coronary Syndrome / Q000401:mortality / Q000601:surgery*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D012042:Registries; D012307:Risk Factors; D012737:Sex Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
keywords: Elderly patients; Octogenarians; Primary percutaneous intervention; Reperfusion; ST segment elevation myocardial infarction