PMID- 26089851
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20150619
LR  - 20200930
IS  - 1671-5411 (Print)
IS  - 1671-5411 (Linking)
VI  - 12
IP  - 3
DP  - 2015 May
TI  - Age and outcomes of primary percutaneous intervention for ST elevation myocardial 
      infarction in a tertiary center-are we there yet?
PG  - 263-9
LID - 10.11909/j.issn.1671-5411.2015.03.007 [doi]
AB  - BACKGROUND: Primary percutaneous intervention (PPCI) is the treatment of choice 
      for ST elevation myocardial infarction (STEMI) but robust evidence in the very 
      elderly is lacking. We compared PPCI outcomes between different age quartiles 
      (quartile 1 < 60 years, quartile 2 >/= 60 to < 70 years, quartile 3 >/= 70 to < 80 
      years, quartile 4 >/= 80 years). METHODS: Retrospective observational analysis of 
      our Morriston Tertiary Cardiac Center (Abertawe Bro Morgannwg University Health 
      Board) patients from 2005 to 2010 with STEMI who underwent PPCI. RESULTS: Of 434 
      patients, 57 (13%) were in quartile 4 (>/= 80 years). In older age quartiles, 
      patients were less likely to receive a drug eluting stent (DES, P = 0.001) or 
      glycoprotein IIb/IIIa inhibitor (GPI, P < 0.0001). Increase in age was associated 
      with reduced time to survival (beta-coefficient: -0.192, t: -3.70, 95%CI: -4.91 to 
      -1.50, P < 0.0001) as was the presence of cardiogenic shock (beta-coefficient: 
      -0.194, t = 3.77, 95%CI: -5.26 to -1.65, P < 0.0001). Use of GPI was associated 
      with increased time to survival (beta-coefficient: 0.138, t = 2.82, 95%CI: 
      1.58-8.58, P = 0.005) but older age quartiles were less likely to receive GPI (P 
      < 0.0001). In-hospital mortality (1.8% quartile 1, 3.6% quartile 2, 10.9% 
      quartile 3 and 12.3% quartile 4, P = 0.002) and 1-year mortality (5.4% quartile 
      1, 5.5% quartile 2, 16.8% quartile 3 and 24.6% quartile 4, P < 0.0001, 
      respectively) was significantly higher in older age quartiles. CONCLUSIONS: 
      Increased short term and intermediate term mortality is seen in the very elderly 
      after PPCI. Age and cardiogenic shock were prognostic factors. Intervention 
      should not be based on age alone and awareness regarding prognostic factors can 
      help improve management.
FAU - Sharma, Vinoda
AU  - Sharma V
AD  - Morriston Cardiac Center, Swansea, Wales, United Kingdom.
FAU - Srinivasan, Manivannan
AU  - Srinivasan M
AD  - Morriston Cardiac Center, Swansea, Wales, United Kingdom.
FAU - Smith, Dave
AU  - Smith D
AD  - Morriston Cardiac Center, Swansea, Wales, United Kingdom.
LA  - eng
PT  - Journal Article
PL  - China
TA  - J Geriatr Cardiol
JT  - Journal of geriatric cardiology : JGC
JID - 101237881
PMC - PMC4460170
OTO - NOTNLM
OT  - Myocardial infarction
OT  - Primary percutaneous intervention
OT  - The elderly
EDAT- 2015/06/20 06:00
MHDA- 2015/06/20 06:01
PMCR- 2015/05/01
CRDT- 2015/06/20 06:00
PHST- 2014/07/10 00:00 [received]
PHST- 2014/12/21 00:00 [revised]
PHST- 2015/02/27 00:00 [accepted]
PHST- 2015/06/20 06:00 [entrez]
PHST- 2015/06/20 06:00 [pubmed]
PHST- 2015/06/20 06:01 [medline]
PHST- 2015/05/01 00:00 [pmc-release]
AID - jgc-12-03-263 [pii]
AID - 10.11909/j.issn.1671-5411.2015.03.007 [doi]
PST - ppublish
SO  - J Geriatr Cardiol. 2015 May;12(3):263-9. doi: 
      10.11909/j.issn.1671-5411.2015.03.007.