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Primary percutaneous coronary intervention in octogenarians
- Source :
- INTERNATIONAL JOURNAL OF CARDIOLOGY, r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau, instname
- Publication Year :
- 2016
-
Abstract
- Background: Limited data are available on the outcome of primary percutaneous coronary intervention (PCI) in octogenarian patients, as the elderly are under-represented in randomized trials. This study aims to provide insights on clinical characteristics, management and outcome of the elderly and very elderly presenting with STEMI. Methods: 2225 STEMI patients >= 70 years old (mean age 76.8 +/- 5.1 years and 53.8% men) were admitted into the network of the ISACS-TC registry. Of these patients, 72.8% were >= 70 to 79 years old (elderly) and 27.2% were >= 80 years old (very-elderly). The primary end-point was 30-day mortality. Results: Thirty-day mortality rates were 13.4% in the elderly and 23.9% in the very-elderly. Primary PCI decreased the unadjusted risk of death both in the elderly (OR: 0.32, 95% CI: 0.24-0.43) and very-elderly patients (OR: 0.45, 95% CI 0.30-0.68), without significant difference between groups. In the very-elderly hypertension and Killip class >= 2 were the only independent factors associated with mortality; whereas in the elderly female gender, prior stroke, chronic kidney disease and Killip class >= 2 were all factors independently associated with mortality. Factors associated with the lack of use of reperfusion were female gender and atypical chest pain in the very-elderly and in the elderly; in the elderly, however, there were some more factors, namely: history of diabetes, current smoking, prior stroke, Killip class >= 2 and history chronic kidney disease. Conclusions: Age is relevant in the prognosis of STEMI, but its importance should not be considered secondary to other major clinical factors. Primary PCI appears to have beneficial effects in the octogenarian STEMI patients. (C) 2016 Published by Elsevier Ireland Ltd.
- Subjects :
- Male
Time Factors
medicine.medical_treatment
health care facilities, manpower, and services
030204 cardiovascular system & hematology
law.invention
0302 clinical medicine
Randomized controlled trial
law
Risk Factors
030212 general & internal medicine
Registries
Stroke
Aged, 80 and over
Mortality rate
Age Factors
Prognosis
humanities
3. Good health
Europe
Survival Rate
Cardiology
Female
Cardiology and Cardiovascular Medicine
Elderly patient
medicine.medical_specialty
Octogenarians
03 medical and health sciences
Percutaneous Coronary Intervention
Sex Factors
Internal medicine
Diabetes mellitus
Octogenarian
medicine
Humans
cardiovascular diseases
Acute Coronary Syndrome
Killip class
Aged
ST segment elevation myocardial infarction
business.industry
Percutaneous coronary intervention
social sciences
medicine.disease
Elderly patients
Conventional PCI
Reperfusion
business
Primary percutaneous intervention
Kidney disease
Subjects
Details
- ISSN :
- 18741754 and 01675273
- Volume :
- 222
- Database :
- OpenAIRE
- Journal :
- International journal of cardiology
- Accession number :
- edsair.doi.dedup.....9454aa8c6bfec8be536848bb8466fa37