PMID- 24500237
OWN - NLM
STAT- MEDLINE
DCOM- 20141009
LR  - 20220330
IS  - 1558-2035 (Electronic)
IS  - 1558-2027 (Linking)
VI  - 15
IP  - 1
DP  - 2014 Jan
TI  - Should primary percutaneous coronary intervention be the routine reperfusion 
      strategy in octogenarians presenting with ST elevation myocardial infarction?
PG  - 53-9
LID - 10.2459/JCM.0b013e3283649978 [doi]
AB  - AIM: Very few randomized trials have analysed the outcome of primary percutaneous 
      coronary intervention (PPCI) for ST elevation myocardial infarction (STEMI) in 
      very elderly patients (>/=80 years). An observational study was performed to 
      evaluate the outcome of PPCI in patients of at least 80 years of age who were 
      admitted to our unit. METHODS: We included all patients undergoing PPCI in our 
      unit from September 2009 to November 2011. RESULTS: Of the 1471 patients who 
      underwent PPCI during the study period, 236 (16%) were at least 80 years of age. 
      The mean age was 85 +/- 4 years (range 80-99 years, median 85 years). There was a 
      significant difference in in-hospital mortality [14.4 vs. 2.9%, odds ratio (OR) 
      5.6, 95% confidence interval (CI) 3.4-9.2, P <0.0001], 30-day mortality (20.3 vs. 
      4%, OR 6.2, 95% CI 4.0-9.5, P <0.0001), 1-year mortality (28.8 vs. 6.2%, OR 6.1, 
      95% CI 4.2-8.8, P <0.0001), 30-day stent thrombosis (1.7 vs. 0.4%, OR 4.2, 95% CI 
      1.1-15.9, P = 0.04) and non-coronary artery bypass grafting major bleed (5.9 vs. 
      3%, OR 2, 95% CI 1.1-3.8, P = 0.03) between patients aged at least 80 years and 
      those less than 80 years. CONCLUSION: The mortality in our patients of at least 
      80 years was similar to the previously published data, despite the advances in 
      PPCI procedures. Considering the increasing number of octogenarian patients with 
      STEMI at the present time, there is a need for a randomized trial to compare the 
      different treatment strategies for STEMI.
FAU - Showkathali, Refai
AU  - Showkathali R
AD  - aDepartment of Cardiology, The Essex Cardiothoracic Centre, Essex bAnglia Ruskin 
      University, Chelmsford, UK.
FAU - Boston-Griffiths, Edney
AU  - Boston-Griffiths E
FAU - Parker, Michael
AU  - Parker M
FAU - Davies, John R
AU  - Davies JR
FAU - Clesham, Gerald J
AU  - Clesham GJ
FAU - Sayer, Jeremy W
AU  - Sayer JW
FAU - Kelly, Paul A
AU  - Kelly PA
FAU - Aggarwal, Rajesh K
AU  - Aggarwal RK
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - J Cardiovasc Med (Hagerstown)
JT  - Journal of cardiovascular medicine (Hagerstown, Md.)
JID - 101259752
SB  - IM
MH  - Age Factors
MH  - Aged, 80 and over
MH  - Coronary Thrombosis/etiology
MH  - England
MH  - Female
MH  - Hemorrhage/etiology
MH  - Hospital Mortality
MH  - Hospitals, High-Volume
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Logistic Models
MH  - Male
MH  - Myocardial Infarction/diagnosis/mortality/*therapy
MH  - Odds Ratio
MH  - Patient Selection
MH  - *Percutaneous Coronary Intervention/adverse effects/mortality
MH  - Propensity Score
MH  - Prospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2014/02/07 06:00
MHDA- 2014/10/10 06:00
CRDT- 2014/02/07 06:00
PHST- 2014/02/07 06:00 [entrez]
PHST- 2014/02/07 06:00 [pubmed]
PHST- 2014/10/10 06:00 [medline]
AID - 01244665-201401000-00008 [pii]
AID - 10.2459/JCM.0b013e3283649978 [doi]
PST - ppublish
SO  - J Cardiovasc Med (Hagerstown). 2014 Jan;15(1):53-9. doi: 
      10.2459/JCM.0b013e3283649978.