J Korean Med Sci.  2013 Jul;28(7):1027-1033. 10.3346/jkms.2013.28.7.1027.

Percutaneous Coronary Intervention for Acute Myocardial Infarction in Elderly Patients with Renal Dysfunction: Results from the Korea Acute Myocardial Infarction Registry

• Lim SY
• Bae EH
• Choi JS
• Kim CS
• Ma SK
• Ahn Y
• Jeong MH
• Kim W
• Woo JS
• Kim YJ
• Cho MC
• Kim CJ
• Kim SW
• Korea Acute Myocardial Infarction Registry Investigators

• KMID: 1777498
• DOI: http://doi.org/10.3346/jkms.2013.28.7.1027

Abstract

This study aimed to evaluate the effects of percutaneous coronary intervention (PCI) on short- and long-term major adverse cardiac events (MACE) in elderly (>75 yr old) acute myocardial infarction (AMI) patients with renal dysfunction. As part of Korea AMI Registry (KAMIR), elderly patients with AMI and renal dysfunction (GFR<60 mL/min) received either medical (n=439) or PCI (n=1,019) therapy. Primary end point was in-hospital death. Secondary end point was MACE during a 1 month and 1 yr follow-up. PCI group showed a significantly lower incidence of in-hospital death (20.0% vs 14.3%, P=0.006). Short-term and long-term MACE rates were higher in medical therapy group (31.9% vs 19.0%; 57.7% vs 31.3%, P<0.001), and this difference was mainly attributed to cardiac death (29.3% vs 17.6%; 51.9% vs 25.0%, P<0.001). MACE-free survival time after adjustment was also higher in PCI group on short-term (hazard ratio, 0.67; confidence interval, 0.45-0.98; P=0.037) and long-term follow-up (hazard ratio, 0.61, confidence interval, 0.45-0.83; P=0.002). In elderly AMI patients with renal dysfunction, PCI therapy yields favorable in-hospital and short-term and long-term MACE-free survival.

Keyword

Acute Myocardial Infarction; Renal Dysfunction; Elderly; Percutaneous Coronary Intervention; Major Adverse Cardiac Event

MeSH Terms

Aged
Aged, 80 and over
Aging
Creatinine/blood
Female
Humans
Male
Myocardial Infarction/*mortality/*therapy
Percutaneous Coronary Intervention/*methods
Registries
Renal Insufficiency/*complications
Republic of Korea
Survival Rate
Treatment Outcome
Creatinine

Figure

• 

  Fig. 1 Adjusted MACE-free survival at 1-month (A) and 12-month (B).

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