Acute myocardial infarction in progressively elderly patients. A comparative analysis of immediate results in patients who underwent primary percutaneous coronary intervention

• Main Authors: Luiz Alberto Mattos, Alexandre Zago, Áurea Chaves, Ibraim Pinto, Luiz Tanajura, Rodolfo Staico, Marinella Centemero, Fausto Feres, Galo Maldonado, Manoel Cano, Andréa Abizaid, Alexandre Abizaid, Amanda G.M.R. Sousa, J. Eduardo Sousa
• Format: Article
• Language: English
• Published: Sociedade Brasileira de Cardiologia (SBC) 2001-01-01
• Series: Arquivos Brasileiros de Cardiologia
• Subjects: angioplasty; myocardial infarction; elderly
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2001000100006
• ISSN: 0066-782X; 1678-4170

OBJECTIVE: Analysis of the in-hospital results, in progressively elderly patients who undergo primary percutaneous coronary intervention (PCI) in the first 24 hours of AMI. METHODS: The patients were divided into three different age groups (60/69, 70/79, and > or = 80 years) and were treated from 7/95 until 12/99. The primary success rate and the occurrence of major clinical events were analyzed at the end of the in-hospital phase. Coronary stent implantation and abciximab use were employed at the intervencionist discretion. RESULTS: We analyzed 201 patients with age ranging from 60 to 93 years, who underwent primary PCI. Patients with ages above 70 were more often female (p=.015). Those with ages above 80 were treated later with PCI (p=.054), and all of them presented with total occlusion of the infarct-related artery. Coronary stents were implanted in 30% of the patients. Procedural success was lower in > or = 80 year old patients (p=.022), and the death rate was higher in > or = 70 years olds (p=.019). Reinfarction and coronary bypass surgery were uncommon events. A trend occurred toward a higher combined incidence of major in-hospital events according to increased age (p=.064). CONCLUSION: Elderly patients ( > or = 70 years) presented with adverse clinical and angiographic profiles and patients > or = 80 years of age obtained reduced TIMI 3 flow success rates after primary PTCA, and those > or = 70 years had a higher death rate.