J Cardiovasc Thorac Res. 2017;9(3):147-151.
doi: 10.15171/jcvtr.2017.25
PMID: 29118947
PMCID: PMC5670336
  Abstract View: 49
  PDF Download: 143

Original Article

In-Hospital and long term results of primary angioplasty and medical therapy in nonagenarian patients with acute myocardial infarction

Muslum Sahin 1 * , Lutfi Ocal 1, Ali Kemal Kalkan 2, Alev Kilicgedik 1, Mehmet Emin Kalkan 1, Burak Teymen 3, Ugur Arslantas 1, Mehmet Muhsin Turkmen 3

1 Kartal Kosuyolu Heart Education and Research Hospital, Department of Cardiology, Istanbul, Turkey
2 Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
3 Emsey Hospital, Department of Cardiology, Istanbul, Turkey

Abstract

Introduction: Although percutaneous coronary intervention is an accepted "first-line" therapy in acute ST elevation myocardial infarction (STEMI) in general population, few data are available on the short- and long-term outcomes of very old patients (age >90 years). Our aim is to evaluate and compare the short and long-term outcomes after primary percutaneous coronary intervention (PPCI) or medical therapy in nonagenarian patients with STEMI.
Methods: We retrospectively identified patients older than 90 years old in our clinic, with acute STEMI who presented within 12 hours after symptoms onset, either underwent PPCI or medically treated. In hospital events and long-term results analyzed subsequently.
Results: From January 2005 to December 2014, 73 patients with STEMI either underwent PPCI (PPCI group n = 42) or had only medical treatment (Non-PPCI group n = 31). Mean age was 92.4 ± 3.1 (90-106). Patients were followed 26.5 ± 20.1 months. Recurrent myocardial infarction during hospitalization was not observed in both groups. In-hospital mortality, cerebrovascular events and acute renal failure rate were similar between two groups (respectively P = 0.797 and P = 1.000, P = 0.288), whereas arrhythmia was significantly higher in the PPCI group ( 0; 21.4%, P = 0.009). Results show re-infarction was similar in both groups (respectively 3.2%; 11.9%, P = 0.382) but mortality in long-term was significantly lower in the PPCI group (respectively 40.9%; 12.9%, P = 0.02).
Conclusion: In nonagenarian patients, with STEMI mortality is very high. Although; in-hospital events were similar, the long-term mortality rate was significantly lower in patients treated with PPCI.
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