Abstract 15837: Primary Angioplasty in Patients Older Than 75 Years: Efficacy, Prognosis at Short and Medium Term and Mortality Predictors
BACKGROUND The efficacy and security of percutaneous coronary interventions (PCI) in elderly patients presenting with STEMI has not been clearly stated.
OBJECTIVES We aimed to assess the clinical and procedure related features as well as the short and medium term prognosis of patients aged ≥ 75 years who underwent primary angioplasty in our institution.
METHODS Our database consisted in 1503 consecutive patients presenting with STEMI who underwent PCI in our institution between years 2006-2010. 344 (22.9%) were aged ≥ 75.
RESULTS Patients aged ≥ 75 years compared with younger ones were more frequently women with a higher prevalence of diabetes, renal failure, anemia and peripheral and cerebral vascular disease. Higher killip class and prevalence of multivessel disease as well as a significant increase in the time from symptom onset to reperfusion were also observed in this group. No differences were found among infarcted area location and procedure success rates between groups (table 1). Overall mortality at 30 days and one year was higher in the older age group (9.2 % vs. 2.85 % p<0.001) & (15.5 % vs. 5.3 % p<0.0001) respectively. No significant differences among non fatal reinfarction rates at 30 days (1.5 vs. 2.8 % p=0,193) and at one year (4.5 % vs. 4.1 % p=0.591) and need for revascularization of treated vessel rates at 30 days (1.5 vs. 2.8 %, p=0.167) and at one year (4.8% vs. 5.5%; p=0.591) were found. In multivariate analysis. Female sex (OR 0.42, p=0.22), age (OR = 1.1, p=0.003), presence of anemia (OR 2.06, p=0.04), LVEF (OR=0.96, p=0.002) and Killip class (OR = 3.95; p=0,001) were independent predictors of overall mortality at medium-term.
CONCLUSIONS Primary PCI in patients aged ≥ 75 has the same success rate than in younger populations without significant differences among the incidences of non fatal reinfarction and need for new revascularization. However, the prognosis benefit is lower with a higher overall mortality rate at short and medium term.
- © 2011 by American Heart Association, Inc.