Interv Akut Kardiol. 2002;1(1):13-20

Primary coronary angioplasty in the elderly

Petr Kala, Martin Poloczek, Otakar Boček, Petr Jeřábek, Petr Neugebauer, Jiřina Kosová

Interní kardiologická klinika FN a LF MU v Brně

Background: Primary PTCA is the method of choice in the reperfusion treatment of the acute ST-elevation myocardial infarction. The question is whether this treatment would be equally effective also in the elderly.

Methods: A retrospective analysis of the 116 patients indicated to the primary PTCA in 2000. The group of patients was divided into 14 patients (10,5 %) in group A aged ≥74 and in 102 younger patients in group B. Basic characteristics of the groups, primary angiographical results and the hospitalization outcome were analysed. Smoking was the only significantly different main risk factor.

Results: In groups A vs. B 8 vs. 37 patients (57,2 resp. 36,3 %) showed signs of heart failure, the average number of diseased coronary arteries was 2,44 vs. 1,94 (p = 0,009) and the temporary heart stimulation was used more often (p = 0,043). Gp IIb/IIIa blockers were administered only in 20 patients (19,6 %) of B group. The infarction related artery was initially occluded (TIMI 0–1) in 78,6 % vs. 80,4 %. The final TIMI flow 2 + 3 was achieved in 85,7 % vs. 98 % (p = 0,02), the artery was not reperfused in 14,3 % vs. 2 % of the patients. The time intervals from the symptom onset to the reperfusion were not significantly different. The in-hospital mortality was 14,3 % vs. 3,9 %, excluding the patients in cardiogenic shock the mortality rate was 8,3 % resp. 1,1 %.

Conclusion: Primary PTCA is in short-term follow-up a very effective method of reperfusion therapy even in the high-risk group of elderly patients.

Keywords: percutaneous coronary angioplasty, primary coronary angioplasty, acute myocardial infarction.

Published: December 31, 2002  Show citation