Outcome of primary percutaneous coronary intervention in Octogenarians with acute myocardial infarction
Journal
Journal of the Formosan Medical Association
Journal Volume
105
Journal Issue
6
Pages
451-458
Date Issued
2006
Author(s)
Abstract
Background/Purpose: Acute myocardial infarction (AMI) results in more complications and increased mortality in octogenarians compared to patients in younger age groups. This study investigated the short- and long-term outcomes in octogenarians after primary percutaneous coronary intervention (PCI). Methods: During the study period from May 1997 to August 2004, 54 patients ? 80 years old with ST-elevation myocardial infarction (STEMI) were eligible for primary PCI. Data collected included baseline clinical characteristics and usage of cardiovascular medications. Diagnostic coronary angiography and revascularization procedures were performed using standard practices. During hospitalization, the clinical course including serial changes in cardiac enzymes, adverse events associated with myocardial infarction or treatment, and inhospital or long-term mortality of patients were recorded. Results: The mean age of the 54 patients (35 men, 19 women) was 82.8 ± 2.5 years (range, 80-89 years). Among them, 27 (50%) had anterior infarction, six (11%) had anterolateral infarction, and 21 (39%) had inferior infarction, inclusive of three patients with accompanying right ventricular infarction. Among them, 20 (37%) patients were in Killip class I, nine (17%) were in class II, two (4%) in class III, and 23 (43%) in class IV. The mean delay from onset of symptoms to arrival in hospital was 220 ± 167 minutes, and 189 ± 169 minutes from hospital arrival to reperfusion. Diagnostic coronary angiography revealed that 48 (89%) patients had multivessel disease. Inhospital death occurred in 23 (43%) patients, with the leading causes of death being profound cardiogenic shock (61%), and free wall rupture (26%). Conclusion: Octogenarian patients who developed STEMI tended to have multivessel disease. These patients had a high in hospital mortality rate that was most likely to be due to cardiogenic shock. ?2006 Elsevier & Formosan Medical Association.
SDGs
Other Subjects
acetylsalicylic acid; antiarrhythmic agent; antilipemic agent; beta adrenergic receptor blocking agent; calcium channel blocking agent; clopidogrel; digitalis; dipeptidyl carboxypeptidase inhibitor; diuretic agent; heparin; nitric acid derivative; ticlopidine; acute heart infarction; aged; angiocardiography; article; cardiogenic shock; cause of death; controlled study; coronary artery recanalization; disease classification; disease course; drug dose regimen; female; geriatric care; hospital patient; hospitalization; human; Kaplan Meier method; major clinical study; male; mortality; outcomes research; pathological anatomy; percutaneous coronary intervention; prognosis; ST segment elevation
Publisher
Scientific Communications International Ltd
Type
journal article