Zimmermann S, Ruthrof S, Nowak K, Klinghammer L, Ludwig J, Daniel W, Flachskampf FA (2009)
Publication Type: Journal article
Publication year: 2009
Book Volume: 32
Pages Range: 87-93
Journal Issue: 2
DOI: 10.1002/clc.20289
Background: Data on contemporary real-world outcomes of interventional revascularization in patients ≥75 y of age with ST elevation infarction (STEMI) are limited. Methods: We analyzed all 504 consecutive patients who underwent angiography for acute STEMI between 1999 and 2005 at our center, and followed them up over one year. Outcomes in patients ≥75 y of age were compared with younger patients. Results: Patients ≥75 y of age (n = 115) were majority females (55% versus 21%, p<0.001), more cases of diabetes (42% versus 27%, p = 0.004), hypertension (78% versus 65%, p = 0.03) and a history of coronary events (25% versus 15%, p = 0.002). Younger patients were more often smokers (63% versus 30%, p<0.001). After coronary angiography patients ≥75 y of age underwent less frequent intervention (PCI; 84% versus 93%, p = 0.01). However, if PCI was performed, technical success rates were similar to younger patients (84% versus 86%). The 30-d mortality was 13% versus 6.4% (p = 0.03), but after successful PCI, the 30-d mortality rate was not significantly higher in old patients (7.4% versus 3.9%, p = 0.23). Bleeding complications were very low in both age groups if the radial access route was chosen. Multivariate predictors of 30-d mortality were cardiogenic shock/survived cardiac arrest, ejection fraction < 30%, conservative treatment or unsuccessful PCI (OR 3.01), renal insufficiency, diabetes, and age. One-y mortality was higher in the elderly (24.3% versus 9.9%, p<0.001). Among 30-d-survivors, only multivessel disease and age were multivariate predictors of 1-ymortality. Conclusion: Patients ≥75 y of age benefit from PCI in STEMI, and failed or unattempted PCI worsens prognosis in the old as well as in younger patients. © 2009 Wiley Periodicals, Inc.
APA:
Zimmermann, S., Ruthrof, S., Nowak, K., Klinghammer, L., Ludwig, J., Daniel, W., & Flachskampf, F.A. (2009). Outcomes of contemporary interventional therapy of ST elevation infarction in patients older than 75 years. Clinical Cardiology, 32(2), 87-93. https://doi.org/10.1002/clc.20289
MLA:
Zimmermann, Stefan, et al. "Outcomes of contemporary interventional therapy of ST elevation infarction in patients older than 75 years." Clinical Cardiology 32.2 (2009): 87-93.
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