Key result
Among 1,268 patients undergoing primary PCI for STEMI, elderly patients (≥70 years) had significantly higher in-hospital mortality and complication rates compared to younger patients.
Why the study?
The clinical characteristics and in-hospital outcomes of elderly South-East Asian patients undergoing primary PCI for STEMI were not well described.
Do elderly South-East Asian patients (≥ 70 years) have worse in-hospital outcomes compared to non-elderly patients when undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction?
Cohort (n=1,268)
No
Do elderly South-East Asian patients (≥ 70 years) have worse in-hospital outcomes compared to non-elderly patients when undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction?
Elderly South-East Asian patients undergoing primary PCI for STEMI have significantly higher in-hospital mortality and complication rates compared to younger patients.
Signals higher in-hospital risks for elderly South-East Asian STEMI patients; leaves open whether age-specific protocols improve outcomes.
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.
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Tong et al. (2016) conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=1,268). Age ≥ 70 years (elderly) vs. Age < 70 years (non-elderly) was evaluated on In-hospital mortality. Among 1,268 patients undergoing primary PCI for STEMI, elderly patients (≥70 years) had significantly higher in-hospital mortality and complication rates compared to younger patients.
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