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Primary percutaneous coronary intervention for ST-segment elevation acute myocardial infarction in nonagenarian

Pablo Salinas1, Guillermo Galeote, Roberto Martin-Reyes

  • 1University Hospital La Paz, Madrid, Spain.

Eurointervention : Journal of Europcr in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
|April 27, 2011
PubMed

Insights

Primary percutaneous coronary intervention is effective in nonagenarians with ST-segment elevation acute myocardial infarction, achieving high success rates. However, in-hospital mortality is significant, particularly in patients experiencing major bleeding or heart failure.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Geriatric Cardiology

Background:

  • Limited data exists on primary percutaneous coronary intervention (PCI) for ST-segment elevation acute myocardial infarction (STEMI) in nonagenarian patients (≥90 years old).
  • Assessing the outcomes of this high-risk population is crucial for clinical decision-making.

Purpose of the Study:

  • To evaluate the efficacy and safety of primary PCI in nonagenarian patients diagnosed with STEMI.
  • To identify factors associated with in-hospital mortality in this patient cohort.

Main Methods:

  • A multicentre registry study was conducted across five tertiary centers in Spain.
  • Included 38 nonagenarian patients with STEMI treated with primary PCI within 12 hours of symptom onset.
  • Data collected included procedural success, angiographic outcomes, and in-hospital mortality.

Main Results:

  • Primary PCI achieved 90% angiographic success and 76% TIMI 3 flow.
  • In-hospital mortality was 34.2%.
  • Mortality was higher in patients with major bleeding (100%), final TIMI flow <3 (71.4%), and Killip class > I (53.3%).

Conclusions:

  • Primary PCI in nonagenarians with STEMI demonstrates a high rate of successful infarct-related artery recanalization.
  • In-hospital mortality is concentrated among patients with severe bleeding, heart failure at admission, and suboptimal final TIMI flow.
Abstract

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