Real-world outcome from ST elevation myocardial infarction in the very elderly before and after the introduction of a 24/7 primary percutaneous coronary intervention service - 05/08/11
Résumé |
Background |
It remains unclear whether the superiority of primary percutaneous coronary intervention (PPCI) over thrombolysis for the treatment of ST elevation myocardial infarction (STEMI) extends to the very elderly. Furthermore, the deliverability and efficacy of PPCI in over the 80s has not been investigated in a real-world setting. The aim of this study was to compare outcome from STEMI in patients aged ≥80 before and after the introduction of routine 24/7 PPCI.
Methods |
Retrospective observational analysis of all patients aged ≥80 presenting with STEMI to 2 neighboring hospitals in the 3-year period after the introduction of a 24/7 PPCI service and in the preceding 2 years when reperfusion therapy was by thrombolysis.
Results |
Two hundred fifty-six STEMI patients aged ≥80 were included. After the introduction of PPCI, 84% (136/161) received reperfusion therapy, 73% PPCI, and 12% thrombolysis, compared to 77% ([73/95] 1% PPCI, 76% thrombolysis) previously. Mortality after inception of PPCI was reduced at 12 months (29% vs 41%, P = .04) and 3 years (43% vs 58%, P = .02). Improved outcome was attributable to treatment by PPCI, which was associated with numerically lower 12-month (26% vs 37%, P = .07) and significantly reduced 3-year (42% vs 55%, P = .05) mortality compared to thrombolysis.
Conclusions |
Primary PCI can be effectively delivered to very elderly patients presenting with ST elevation MI in a real-world setting and leads to a substantial reduction in mortality compared to patients treated by thrombolysis.
Le texte complet de cet article est disponible en PDF.Plan
Vol 159 - N° 6
P. 956-963 - juin 2010 Retour au numéro
Article précédent
- Acute decompensated heart failure syndromes (ATTEND) registry. A prospective observational multicenter cohort study: Rationale, design, and preliminary data
- Naoki Sato, Katsuya Kajimoto, Kuniya Asai, Masayuki Mizuno, Yuichiro Minami, Michitaka Nagashima, Koji Murai, Ryo Muanakata, Dai Yumino, Tomomi Meguro, Masatoshi Kawana, Jun Nejima, Toshihiko Satoh, Kyoichi Mizuno, Keiji Tanaka, Hiroshi Kasanuki, Teruo Takano, for the ATTEND Investigators j
- Early dynamic risk stratification with baseline troponin levels and 90-minute ST-segment resolution to predict 30-day cardiovascular mortality in ST-segment elevation myocardial infarction: Analysis from CLopidogrel as Adjunctive ReperfusIon TherapY (CLARITY) - Thrombolysis in Myocardial Infarction (TIMI) 28
- Matthew W. Sherwood, David A. Morrow, Benjamin M. Scirica, Songtao Jiang, Christoph Bode, Nader Rifai, Robert E. Gerszten, C. Michael Gibson, Christopher P. Cannon, Eugene Braunwald, Marc S. Sabatine
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?