Korean Circ J.  2005 Aug;35(8):613-619. 10.4070/kcj.2005.35.8.613.

Long-Term Clinical Outcomes after Primary Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction Older than 75 Years

• Lim SY
• Jeong MH
• Yang BR
• Kim KH
• Sohn IS
• Hong YJ
• Park HW
• Kim JH
• Kim W
• Ahn YK
• Cho JG
• Park JC
• Kang JC

• KMID: 2093948
• DOI: http://doi.org/10.4070/kcj.2005.35.8.613

Abstract

BACKGROUND AND OBJECTIVES
Primary percutaneous coronary intervention (PCI) has been found to be superior, in terms of hospital mortality and long-term follow-up, compared with thrombolytic therapy for acute myocardial infarction (AMI). However, the clinical benefits of primary PCI have not been precisely evaluated in elderly patients.
SUBJECTS AND METHODS
Two hundred and twenty three patients (Group I: n=66, age> or =75 years, Group II: n=157, age<75 years), who underwent primary PCI for AMI at Chonnam National University Hospital, between 2000 and 2002, were analyzed according to their clinical, angiographic characteristics, inhospital and one-year survival.
RESULTS
Group I had a higher percentage of women (45.5% vs. 19.1%, p=0.00), multi-vessel disease (42% vs. 28%, p=0.031), right coronary artery disease (52% vs. 33%, p=0.021), and more frequent histories of diabetes mellitus (35% vs. 22%, p=0.039) and less smoking (38% vs. 60%, p=0.003) than Group II. Successful reperfusion by PCI was achieved in 97 and 96 %, respectively (p=NS). The rates of in-hospital mortality were similar in both groups (12.1% vs. 8.2%, p=NS). There were no significant differences in the major adverse cardiac events between the two groups during the one-year clinical follow-up (31.4 % vs. 36.9 %, p=NS).
CONCLUSION
Primary PCI in AMI patients older than 75 years can be performed with comparable procedural success rates and long-term clinical outcomes to those of younger patients.

Keyword

Elderly; Myocardial infarction; Angioplasty

MeSH Terms

Aged
Angioplasty
Coronary Artery Disease
Diabetes Mellitus
Female
Follow-Up Studies
Hospital Mortality
Humans
Jeollanam-do
Myocardial Infarction*
Percutaneous Coronary Intervention*
Reperfusion
Smoke
Smoking
Thrombolytic Therapy
Smoke