Abstract 13379: Does Aggressive Intervention in Elderly Patients With STEMI Improve Survival?
Background: Emergent cardiac catheterization with rapid reperfusion has become the standard of care for patients with STEMI. An increasing proportion of elderly (age ≥75 years) and very elderly (age ≥85 years) patients with STEMI undergo cardiac catheterization, yet there is a paucity of data on the benefits of emergent intervention in these patients.
Methods: We reviewed the medical records of 2,323 patients presenting with STEMI to 11 central Massachusetts medical centers biennially from 1997 to 2007, and examined patient mortality through 2012.
Results: Among patients presenting with STEMI, 34.5% were ≥75 years old and 10.9% were ≥ 85 years old. Among patients ≥75 years old presenting with STEMI, the average age was 82.5 years, 59.7% were female, and 67.3% presented with an initial acute myocardial infarction. In 1997, 30.1% of patients ≥75 years underwent cardiac catheterization during their hospitalization for STEMI and 9.6% received an intervention; in 2007, 74.0% of patients ≥75 years underwent catheterization and 61.0% received an intervention. Among all patients ≥75 years hospitalized for STEMI in 1997 and 2007, respectively, in-hospital mortality (18.7%; 21.3%), and overall mortality at 30-days (23.5%; 25.3%) and at 1-year (33.7%; 36.0%) were not significantly changed.
Conclusion: In this community-wide study of patients presenting with STEMI, a marked increase in aggressive management over time was not associated with improved survival in elderly patients.
- © 2013 by American Heart Association, Inc.