Abstract 18109: Primary Angioplasty in Nonagenarian Patients. Results From a Spanish Multicenter Registry
Introduction: In spite of the increasing number of very elderly patients admitted with STEMI there are very few published data about nonagenarian patients treated with primary angioplasty (PA).
Methods: we conducted a multicenter registry focused on nonagenarian (≥ 90 years old) patients treated with PCI, gathering data from 5 tertiary centers in Spain. We selected those patients admitted with STEMI who presented within 12 hours after symptoms onset and who were treated with PA.
Results: A total of 36 patients were included. Mean age was 91.5 (range 90–98). Baseline characteristics: 56% women, 39% hypertension, 14% dyslipidemia, 14% diabetes, 11% smokers, 8% prior myocardial infarction, 8% prior revascularization, mean LVEF 43.5±11%. At admission, 83% were in Killip class 1 or 2, and 11% in shock. Coronary multivessel disease was found in 57% of the patients, but the mean number of vessels treated per patient was 1.1±0.5 vessels, showing a strategy of treating the culprit vessel only. An average of 1.3±0.6 stents were used per patient (83% bare metal stents). Glycoprotein IIb / IIIa inhibitors were used in 8%. Angiographic success was achieved in 90%, and TIMI 3 flow in 76% of cases. In-hospital mortality was 34.2%, concentrated in patients with major bleeding (100% vs. 31.4%, p=0.048), final TIMI flow grade I at admission (53.3% vs. 21.7%, p=0.045).
Conclusions: PA in nonagenarians with STEMI is associated with high rate of successful recanalization of the infarct-related artery. In-hospital mortality is substantial but concentrated in patients with severe bleeding during hospitalization, heart failure at admission, and final TIMI flow < 3.
- © 2010 by American Heart Association, Inc.