Abstract 14921: Influence of Primary PCI on the Mortality of Very Old Patients With ST-segment Elevation Myocardial Infarction
Introduction: ST-segment elevation myocardial infarction (STEMI) is a life threatening acute event with impaired long - term prognosis in particular in elderly patients (pts). Until now there is only limited information about the effectiveness and the impact on short - and long - term survival of primary PCI in very old patients.
Methods: Since 2006 all patients with STEMI from the metropolitan area of Bremen (Germany) were admitted to the Bremen heart center and documented in the Bremen STEMI-registry (BSR). The study population comprised 5263 pts and was divided by age into three groups (G): G1: <80 years, G2: 80-89 years, G3: >89 years. The outcome of pts treated with primary PCI was analysed regarding inhospital mortality (IM) and mortality after one year (1yM). Furthermore bleeding rates, use of glycoprotein IIb/IIIa inhibitors (GPI), Killip class and signs of cardiogenic shock were assessed during initial hospital stay.
Results: A total of 5263 pts admitted from January 2006 until May 2013 were included in this analysis. A higher overall mortality was associated with higher age. In each subgroup (G1-3) the 1yM was almost twice as high compared to the corresponding IM. Killip class and signs of cardiogenic shock were highest in G2 suggesting a preselection before admittance within the pts >89 years (G3). Despite treatment with GPI was less frequently observed in elderly pts (G2 and G3), bleedings appeared to occur more often in these subgroups.
Conclusions: Even very old patients with STEMI can be treated successfully with primary PCI. Despite an initially successful PCI, lower application rate of GPI, and preselection before admittance, very old patients demonstrate a higher rate of bleeding events as well as short - and long - term mortality. Every second very old patient affected by a STEMI and successfully treated by primary PCI did not survive the first year.
Author Disclosures: R. Zabrocki: None. S. Bünger: None. A. Fach: None. E. Fiehn: None. J. Schmucker: None. H. Wienbergen: None. D. Garstka: None. R. Hambrecht: None.
- © 2014 by American Heart Association, Inc.