In:
Clinical Cardiology, Wiley, Vol. 37, No. 9 ( 2014-09), p. 523-529
Abstract:
Elderly patients are at high risk of mortality when they present with ST ‐elevation myocardial infarction ( STEMI ). However, few data exist about prognostic factors in this sub‐group when treated with primary percutaneous coronary intervention ( pPCI ). Hypothesis To assess outcome and predictors of mortality among patients aged 〉 80 years treated with pPCI. Methods We evaluated 139 consecutive patients (age 85.1 ± 3.9 years, 43.2% males) who underwent pPCI for STEMI . Results Male patients were younger and were more likely to have a history of coronary artery disease. Overall 30‐day and 1‐year mortality rates were 20.9% and 28.1%, respectively. Thrombolysis in Myocardial Infarction ( TIMI ) flow 3 was achieved in 82% of patients. There was a pPCI success rate in male patients. At univariable analysis, older age, diabetes mellitus, Killip class 〉 III , left ventricular ejection fraction ( LVEF ) 〈 40%, no use of stent, failure of pPCI , systolic blood pressure ( SBP ) 〈 100 mm Hg, and infarct‐related artery (left anterior descending vs others) were associated with higher 1‐year mortality. Multivariate analysis identified LVEF 〈 40% (hazard ratio: [ HR ] = 3.70; 95% confidence interval [ CI ]: 1.30‐7.87; P = 0.0001), age (1‐year step, HR : 1.13; 95% CI : 1.04‐1.23; P = 0.007), failure of pPCI ( HR : 2.93; 95% CI : 1.44‐5.98; P = 0.0001), Killip class ≥ III ( HR : 2.29; 95% CI : 1.03‐5.4; P = 0.04) and SBP 〈 100 mm Hg ( HR : 2.64; 95% CI : 1.22‐5.19; P = 0.01) to be independently associated with increased 1‐year mortality. Conclusions Our data show that elderly patients with STEMI have a high risk of mortality, which is particularly high in the first 30 days. Older age, LVEF 〈 40% at admission, hemodynamic instability (higher Killip class or low SBP ), and postinterventional TIMI flow 〈 3 were independent predictors of mortality in our population.
Type of Medium:
Online Resource
ISSN:
0160-9289
,
1932-8737
DOI:
10.1002/clc.2014.37.issue-9
Language:
English
Publisher:
Wiley
Publication Date:
2014
detail.hit.zdb_id:
2048223-1
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