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In-hospital clinical outcomes of elderly patients (≥60 years) undergoing primary percutaneous coronary intervention

Ya-Min Su1, Xing-Xing Cai1, Hai-Hua Geng1

  • 1Department of Cardiology, Affiliated Hospital of Nantong University Nantong 226001, P. R. China.

International Journal of Clinical and Experimental Medicine
|September 18, 2015
PubMed

Insights

Elderly patients undergoing primary percutaneous coronary intervention (PPCI) for ST-elevation myocardial infarction (STEMI) have high in-hospital mortality, mainly from cardiac shock and arrhythmias, despite successful procedures.

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Interventional Cardiology

Background:

  • Elderly patients with ST-elevation myocardial infarction (STEMI) face elevated mortality risks.
  • Clinical outcomes for elderly STEMI patients undergoing primary percutaneous coronary intervention (PPCI) require further elucidation despite technological advancements.

Purpose of the Study:

  • To evaluate the clinical outcomes and identify mortality predictors in elderly patients (≥60 years) who underwent PPCI for STEMI.
  • To compare the efficacy and safety of PPCI in elderly versus non-elderly STEMI patients.

Main Methods:

  • Retrospective cohort study conducted at a single Chinese center.
  • 184 consecutive STEMI patients undergoing PPCI between January 2011 and December 2013 were analyzed.
  • Patients were categorized into elderly (≥60 years) and non-elderly groups, with primary endpoints of angiographic and procedural success, and secondary endpoint of in-hospital mortality.

Main Results:

  • The elderly group (116 patients) showed similar immediate angiographic success (93.97% vs. 94.12%) and procedural success (90.52% vs. 94.12%) rates compared to the non-elderly group.
  • In-hospital mortality was significantly higher in the elderly group (8.62%) than in the non-elderly group (1.47%, P=0.048).
  • Major causes of death in elderly patients included cardiac shock and malignant arrhythmias (ventricular tachycardia/fibrillation).

Conclusions:

  • Primary percutaneous coronary intervention (PPCI) is technically feasible in elderly STEMI patients, achieving high rates of immediate angiographic and procedural success.
  • Despite procedural success, elderly patients exhibit a statistically significant higher risk of in-hospital mortality following PPCI for STEMI.
  • Cardiac shock and malignant arrhythmias are the primary drivers of mortality in this vulnerable elderly population.

Keywords:
Coronary artery diseaseST-elevation myocardial infarctionelderlyprimary percutaneous coronary intervention

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