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Influence of Age on Long-Term Outcome After Emergent Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction

Lookup NU author(s): Dr Timothy Williams


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Background Percutaneous coronary intervention (PCI) provides advantages compared to thrombolytic therapy in the treatment of ST-elevation myocardial infarction (STEMI) Elderly patients have increased in-hospital mortality the predictors of adverse outcomes are not well established, with limited data available regarding late follow up of these patients We evaluated early and late outcomes of patients undergoing emergent PCI for STEMI to identify the predictors of subsequent lite adverse events and, in particular determine if age alone was a predictor of an adverse outcome Materials and Methods A retrospective review of all patients referred for emergent PCI for STI MI to a single tertiary referral center was performed All patients undergoing primary PCI for STEMI or rescue PCI for failed thrombolysis between December 2003 and December 2007 were included for assessment Results During the study period, 269 patients underwent primary or rescue PCI for STEMI Patients >= 70 years of age were more likely to have established cardiovascular risk factors and documented coronary artery disease Thrombolysis in myocardial infarction (TIMI) 3 flow predicted a good outcome, whereas recurrent ischemia in hospital prior aspirin therapy and discharge creatinine predicted a poor outcome age alone was not an adverse prognostic factor Conclusions The increased mortality in elderly patients undergoing PCI for STI MI reflects comorbidity and suboptimal procedural outcomes rather than any age effect per se Future approaches to optimize the management of STEMI in the elderly should include identification of those patients most likely to benefit from an invasive approach

Publication metadata

Author(s): Hiew C, Williams T, Hatton R, Narasimhan S, O'Connor S, Baker F, McElduff P, Attia J, Collins N

Publication type: Article

Publication status: Published

Journal: Journal of Invasive Cardiology

Year: 2010

Volume: 22

Issue: 6

Pages: 273-277

Print publication date: 01/06/2010

ISSN (print): 1042-3931

ISSN (electronic): 1557-2501

Publisher: HMP Communications, LLC