title: Primary Angioplasty in Patients Older Than 75 Years. Profile of Patients and Procedures, Outcomes, and Predictors of Prognosis in the ESTROFA IM+75 Registry.
abstract: OBJECTIVE
  The proportion of elderly patients undergoing primary angioplasty is growing. The present study describes the clinical profile, procedural characteristics, outcomes, and predictors of outcome.
  
  
  METHODS
  A 31-center registry of consecutive patients older than 75 years treated with primary angioplasty. Clinical and procedural data were collected, and the patients underwent clinical follow-up.
  
  
  RESULTS
  The study included 3576 patients (39.3% women, 48.5% with renal failure, 11.5% in Killip III or IV, and 29.8% with>6hours of chest pain). Multivessel disease was present in 55.4% and nonculprit lesions were additionally treated in 24.8%. Radial access was used in 56.4%, bivalirudin in 11.8%, thromboaspiration in 55.9%, and drug-eluting stents in 26.6%. The 1-month and 2-year incidences of cardiovascular death were 10.1% and 14.7%, respectively. The 2-year rates of definite or probable thrombosis, repeat revascularization, and BARC bleeding>2 were 3.1%, 2.3%, and 4.2%, respectively. Predictive factors were diabetes mellitus, renal failure, atrial fibrillation, delay to reperfusion>6hours, ejection fraction<45%, Killip class III-IV, radial access, bivalirudin, drug-eluting stents, final TIMI flow of III, and incomplete revascularization at discharge.
  
  
  CONCLUSIONS
  Notable registry findings include frequently delayed presentation and a high prevalence of adverse factors such as renal failure and multivessel disease. Positive procedure-related predictors include shorter delay, use of radial access, bivalirudin, drug-eluting stents, and complete revascularization before discharge.
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain. Electronic address: he1thj@humv.es.
authors.forename: José M
authors.initials: JM
authors.lastname: de la Torre Hernández
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Clínic, Barcelona, Spain.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Brugaletta
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Joan A
authors.initials: JA
authors.lastname: Gómez Hospital
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital de Vigo, Vigo, Pontevedra, Spain.
authors.forename: José A
authors.initials: JA
authors.lastname: Baz
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital de León, León, Spain.
authors.forename: Armando
authors.initials: A
authors.lastname: Pérez de Prado
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital de San Juan, San Juan de Alicante, Alicante, Spain.
authors.forename: Ramón
authors.initials: R
authors.lastname: López Palop
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
authors.forename: Belén
authors.initials: B
authors.lastname: Cid
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain.
authors.forename: Tamara
authors.initials: T
authors.lastname: García Camarero
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Clínico de Salamanca, Salamanca, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Diego
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Clínico de Valladolid, Valladolid, Spain.
authors.forename: Federico
authors.initials: F
authors.lastname: Gimeno de Carlos
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain.
authors.forename: José A
authors.initials: JA
authors.lastname: Fernández Díaz
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Clínico de Valencia, Valencia, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Sanchis
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital de La Princesa, Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Alfonso
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital de Cruces, Bilbao, Vizcaya, Spain.
authors.forename: Roberto
authors.initials: R
authors.lastname: Blanco
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Fundación Alcorcón, Alcorcón, Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Botas
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital General de Albacete, Albacete, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Navarro Cuartero
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Virgen de la Salud, Toledo, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Moreu
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Bosa
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital de Cabueñes, Gijón, Asturias, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Vegas Valle
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Gregorio Marañón, Madrid, Spain.
authors.forename: Jaime
authors.initials: J
authors.lastname: Elízaga
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Virgen de las Nieves, Granada, Spain.
authors.forename: Antonio L
authors.initials: AL
authors.lastname: Arrebola
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Clínico de Zaragoza, Zaragoza, Spain.
authors.forename: José R
authors.initials: JR
authors.lastname: Ruiz Arroyo
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Felipe
authors.initials: F
authors.lastname: Hernández-Hernández
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital del Mar, Grup de Recerca Biomèdica en Malalties del Cor, IMIM (Hospital del Mar Research Institute), Barcelona, Spain.
authors.forename: Neus
authors.initials: N
authors.lastname: Salvatella
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Dr. Peset, Valencia, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Monteagudo
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Son Espases, Palma de Mallorca, Baleares, Spain.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Gómez Jaume
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Carrillo
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Roberto
authors.initials: R
authors.lastname: Martín Reyes
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital de Ciudad Real, Ciudad Real, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Lozano
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital de Galdakao, Vizcaya, Spain.
authors.forename: José R
authors.initials: JR
authors.lastname: Rumoroso
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital de Basurto, Bilbao, Vizcaya, Spain.
authors.forename: Leire
authors.initials: L
authors.lastname: Andraka
authors.affiliation: Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Virgen de la Victoria, Málaga, Spain.
authors.forename: Antonio J
authors.initials: AJ
authors.lastname: Domínguez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D002423:Cause of Death / Q000639:trends; D015897:Comorbidity; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011379:Prognosis; D012008:Recurrence; D012042:Registries; D051437:Renal Insufficiency / Q000453:epidemiology*; D012189:Retrospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
keywords: Anciano; Angioplastia primaria; Elderly; Infarto de miocardio; Myocardial infarction; Primary angioplasty