Interv Akut Kardiol. 2003;2(3):124-128

Primary PCI at the age of 70 and more - results of the middle-term follow-up

Petr Kala, Martin Poloczek, Petr Neugebauer, Otakar Boček, Petr Jeřábek, Miroslav Vytiska, Jiří Pařenica, Tomáš Brychta

Interní kardiologická klinika FN a LF MU v Brně

Background: Short-term results of the primary coronary intervention (primary PCI) are mostly very good. There is a need to accept the significant worse results during the follow-up in the group of elderly patients.

Aim: To compare the middle-term follow-up results of the consecutive patients divided into two groups according their age (70 years).

Methods: A prospective analysis of 116 consecutive patients with acute ST-elevation myocardial infarction who were treated with primary PCI in the period from January 2000 to the end of December 2000. The whole group of patients at the age 65.4 on average (38–96 years old) was divided into two groups: 41 patients (35.3 %) at the age of 70 and more (74.8 ± 4.9) created group A and 75 (64.7 %) younger patients (56 ± 8.5 years) created group B. After that both groups were statistically compared according to the occurrence of the combined clinical end-point (MACE = mortality, reinfarction and target vessel revascularization) in the 6-month follow-up and according to the hospital outcome.

Results: The combined clinical end-point was achieved in 11 patients (14.6 %) in group A and in 1 patient (1.3 %) in group B (p = 0.02) during the follow-up. This statistically significant difference was due to higher mortality in the elderly (14.6 % vs. 0 %, p < 01). This statistically significant difference was due to higher mortality in the elderly (19.5 % vs. 2.8 %, p = 0,005). The difference appeared already during the acute in-hospital phase of the disease and after that did not increase. The achievement of the primary end-point did not distinguish in patients surviving the in-hospital phase. No statistical difference was observed in the reinfarction and the target vessel revascularization rate (4.9 % vs. 4.3 %, p = 0.61 resp. 2.4 % vs. 2.9 %, p = 0.69).

Conclusion: The paper proved success and relative safety of the mechanical reperfusion treatment in the elderly at the age of 70 and more. Although the work concerned a group of patients with high cardiovascular risk, that was reflected in higher in-hospital mortality rate of the acute illness, the followed middle-term results of the unselected group of patients were unexpectedly positive.The high cardiovascular risk was reflected in higher in-hospital mortality in this group of patients.

Keywords: primary coronary intervention, acute myocardial infarction, elderly.

Published: December 31, 2003  Show citation