Why the study?
Does primary PCI yield comparable clinical outcomes in elderly patients (≥75 years) with STEMI compared to younger patients?
Cohort (n=296)
Does primary PCI yield comparable clinical outcomes in elderly patients (≥75 years) with STEMI compared to younger patients?
Primary PCI in elderly patients (≥75 years) with STEMI is safe and associated with comparable 6-month clinical outcomes to younger patients, despite a slightly lower procedural success rate.
Answers are grounded in this paper and cite their sources.
May support primary PCI in selected elderly STEMI patients; leaves open need for randomized confirmation.
AIM: To investigate the outcome of primary percutaneous coronary interventions (PCI) in elderly patients (>/=>/=75 years) with ST-elevation myocardial infarction (STEMI). METHODS AND RESULTS: Between 1995 and 2003, a total of 319 consecutive patients with acute ST-elevation myocardial infarction presenting within 6-12 hr after onset of symptoms were prospectively enrolled in a registry. Of 296 patients undergoing primary PCI, 40 patients were >/=>/=75 years old (group A) and 256 patients younger than 75 years (group B). Elderly patients presented with a lower ejection fraction (49 +/- 14% vs. 53 +/- 13%, P = 0.046) and a higher number of cardiovascular risk factors. PCI success was achieved in 80% (group A) and 91% (group B, P = 0.031), respectively with comparable door-to-balloon times (87 +/- 49 and 95 +/- 79 min, P = ns). Periprocedural complications in both groups were low and major adverse cardiac events (death, myocardial infarction, target vessel revascularization and cardiac rehospitalization) after 6 months amounted to 23% (group A) and 20% (group B, P = ns), respectively. CONCLUSIONS: Clinical outcome of elderly patients (>/=>/=75 years) with acute STEMI is favorable and comparable with the middle-aged population. However, procedural success was significantly lower in elderly (80%) compared to younger patients (90%). Acute percutaneous coronary intervention appears to be safe and not associated with higher periprocedural complications, in elderly patients.
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Wenaweser et al. (2007) conducted a cohort in Acute ST-elevation myocardial infarction (STEMI) (n=296). Age ≥75 years vs. Age <75 years was evaluated on Major adverse cardiac events (death, myocardial infarction, target vessel revascularization and cardiac rehospitalization) at 6 months (p=ns).
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