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Geriatr Gerontol Int. 2013 Jul;13(3):711-7. doi: 10.1111/ggi.12005. Epub 2012 Dec 21.

Trends in mortality rates in elderly ST elevation myocardial infarction patients submitted to primary percutaneous coronary intervention: a 7-year single-center experience.

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1
Intensive Cardiac Coronary Unit, Heart and Vessel Department, Teaching Hospital Careggi, Florence, Italy. lazzeric@libero.it

Abstract

AIM:

Limited data are available on the safety and outcome of percutaneous coronary intervention (PCI) in elderly patients with ST elevation myocardial infarction (STEMI), as elderly patients are under-represented in randomized trials.

METHODS:

We therefore aimed at assessing the trends in mortality rates (both at short-term and at 1-year follow up) in an unselected cohort of 404 STEMI patients aged ≥ 75 years all submitted to primary PCI and consecutively admitted to our Intensive Cardiac Care Unit from 2004 to 2010.

RESULTS:

In the first period (2004-2006), 202 patients (202/661, 30.6%) were aged ≥ 75 years, whereas in the second period (2007-2010), 203 patients (203/607, 33.4%) were aged ≥ 75 years. In the second period, STEMI patients were older (P<0.001), more diabetic (P<0.001) and with a higher incidence of comorbidities (P<0.001). A significantly lower use of intra-aortic balloon pump was observed, together with a reduced rate of bleeding, whereas the incidence of worsening renal function significantly increased (P=0.011). No difference was observed in the length of stay and in mortality rate (both in-hospital and 1-year post-discharge) between the first and the second period.

CONCLUSIONS:

According to our data, patients aged ≥ 75 years are characterized by an increasing number of comorbidities (in particular, a higher incidence of diabetes). Over a 6-year period, despite a more advanced age, early mortality (and length of stay) remained unchanged (probably thanks to a significant reduction in bleeding events), and no difference was observed in 1-year post-discharge mortality in these patients.

KEYWORDS:

ST elevation myocardial infarction; elderly; long-term follow up; percutaneous coronary intervention; prognosis

PMID:
23279734
DOI:
10.1111/ggi.12005
[Indexed for MEDLINE]
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