title: Clinical outcomes of elderly South-East Asian patients in primary percutaneous coronary intervention for ST-elevation myocardial infarction.
abstract: OBJECTIVE
  To evaluate the clinical characteristics and in-hospital outcomes of elderly South-East Asian patients undergoing primary percutaneous coronary intervention (PPCI).
  
  
  METHODS
  From January 2009 to December 2012, 1268 patients (86.4% male, mean age of 58.4 ± 12.2 years) presented to our hospital for ST-elevation myocardial infarction (STEMI) and underwent PPCI. They were divided into two groups: elderly group defined as age ≥ 70 years and non-elderly group defined as age < 70 years. Data were collected retrospectively on baseline clinical characteristics, door-to-balloon (D2B) time, angiographic findings, therapeutic modality and hospital course.
  
  
  RESULTS
  The elderly group constituted 19% of the study population with mean age 76.6 ± 5.0 years. There was a higher proportion of female gender and ethnic Chinese patients in the elderly group when compared with the non-elderly group. The former was less likely to be smokers and have a significantly higher prevalence of hypertension. The mean D2B time was significantly longer in the elderly group. They also had a significantly higher incidence of triple vessel disease and obstructive left main disease. The use of radial artery access, glycoprotein 2b/3a inhibitors and drug-eluting stents during PPCI were also significantly lower. In-hospital mortality was significantly higher in the elderly group. The rate of cardiogenic shock and inhospital complications were also significantly higher.
  
  
  CONCLUSIONS
  Our registry showed that in-hospital mortality rate in elderly South-East Asian patients undergoing PPCI for STEMI was high. Further studies into the optimal STEMI management strategy for these elderly patients are warranted.
authors.affiliation: Department of Cardiology, Tan Tock Seng Hospital, Singapore.
authors.forename: Jieli
authors.initials: J
authors.lastname: Tong
authors.affiliation: Clinical Research & Innovation Office, Tan Tock Seng Hospital, Singapore.
authors.forename: Wen Wei
authors.initials: WW
authors.lastname: Xiang
authors.affiliation: Department of Cardiology, Tan Tock Seng Hospital, Singapore.
authors.forename: An Shing
authors.initials: AS
authors.lastname: Ang
authors.affiliation: Department of Cardiology, Tan Tock Seng Hospital, Singapore.
authors.forename: Wen Jun
authors.initials: WJ
authors.lastname: Sim
authors.affiliation: Department of Cardiology, Tan Tock Seng Hospital, Singapore.
authors.forename: Kien Hong
authors.initials: KH
authors.lastname: Quah
authors.affiliation: Department of Cardiology, Tan Tock Seng Hospital, Singapore.
authors.forename: David
authors.initials: D
authors.lastname: Foo
authors.affiliation: Department of Cardiology, Tan Tock Seng Hospital, Singapore.
authors.forename: Paul Jau Lueng
authors.initials: PJ
authors.lastname: Ong
authors.affiliation: Department of Cardiology, Tan Tock Seng Hospital, Singapore.
authors.forename: Hee Hwa
authors.initials: HH
authors.lastname: Ho
keywords: Cardiovascular disease; Door-to-balloon time; Percutaneous coronary intervention; ST-elevation myocardial infarction