Turk Kardiyol Dern Ars. 2013; 41(4): 319-328 | DOI: 10.5543/tkda.2013.76059
Comparison of early and late clinical outcomes in patients ≥80 versus <80 years of age after successful primary angioplasty for ST segment elevation myocardial infarction
, Ayhan Erkol2
, Ali Cevat Tanalp3
, Cevat Kırma4
, Mustafa Bulut4
, Atila Bitigen1
, Selçuk Pala4
, Kürşat Tigen5
, Ali M. Esen41
Department of Cardiology, Medical Park Fatih Hospital, İstanbul, Turkey2
Department of Cardiology, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey3
Department of Cardiology, Medicana International Hospital, Ankara, Turkey4
Department of Cardiology, Kartal Koşuyolu Heart Training and Research Hospital, İstanbul, Turkey5
Department of Cardiology, Marmara University Faculty of Medicine, Istanbul, Turkey
OBJECTIVES We aimed to compare the efficacy of primary percutaneous coronary intervention (p-PCI) in patients ≥80 versus <80 years of age with ST-segment elevation myocardial infarction (STEMI).
STUDY DESIGN We retrospectively enrolled 2213 patients with acute STEMI. The patients were prospectively followed up for a median of 42 months. Early and late clinical outcomes were compared according to age.
RESULTS One-hundred and seventy-nine (8.1%) of the 2213 patients were aged ≥80 years. Post-procedural TIMI grade 3 flow was significantly less frequent in the age ≥80 years patients (82.1% vs. 91.1%, p<0.001). Rates of mortality (14.5% vs. 3.4%, p<0.001), heart failure (20.7% vs. 10.5%, p<0.001), major hemorrhage (9.5% vs. 3.3%, p<0.001), secondary VT/VF (10.1% vs. 4.2%, p=0.002) and atrial fibrillation (12.8% vs. 4.3%, p<0.001) during the early hospitalization period were significantly higher in the age ≥80 years patient group. Overall rates of mortality (40% vs. 9.7%, p<0.001) and total stroke (5.6% vs. 1.1%, p=0.005) at long-term follow-up were also higher in the age ≥80 years patient group. However, there was no difference between the two groups with respect to the reinfarction/revascularization rates. Analysis, using the Cox proportional hazards model, revealed that age ≥80 to was an independent predictor of longterm mortality (hazard ratio 2.17, 95% CI 1.23-4.17, p=0.02).
CONCLUSION Age is an independent predictor of mortality after p-PCI for STEMI. Although it seems to improve early outcomes, the efficacy of p-PCI at long-term follow-up is limited in elderly patients.
Age factors, myocardial infarction/etiology/therapy; percutaneous coronary intervention; treatment outcome.
Vecih Oduncu, Ayhan Erkol, Ali Cevat Tanalp, Cevat Kırma, Mustafa Bulut, Atila Bitigen, Selçuk Pala, Kürşat Tigen, Ali M. Esen. Comparison of early and late clinical outcomes in patients ≥80 versus <80 years of age after successful primary angioplasty for ST segment elevation myocardial infarction. Turk Kardiyol Dern Ars. 2013; 41(4): 319-328
Corresponding Author: Ayhan Erkol, Türkiye