[A case review: About a STEMI in the very elderly].

Area of Science:

• Cardiology
• Geriatric Medicine
• Interventional Cardiology

Background:

• Increasing prevalence of coronary artery disease in the aging population necessitates treatment strategies for very elderly patients (>90 years).
• Limited evidence-based medicine exists for this demographic, yet registries offer guidance.

Observation:

• Age should not be a contraindication for reperfusion therapies in myocardial infarction.
• Primary angioplasty demonstrates technical success rates similar to younger populations and is the preferred treatment.
• Radial arterial access is recommended for primary angioplasty in this age group.

Findings:

• Thrombolysis has not been studied in patients >90 years, unlike in octogenarians.
• While complications like bleeding, neurological, and ischemic events are more frequent, survivors experience similar or improved survival rates.
• Initial hemodynamic compromise increases complication risks.

Implications:

• Primary angioplasty via radial access is a viable and effective treatment for very elderly myocardial infarction patients.
• Adherence to therapeutic recommendations, considering comorbidities and organ function, is crucial for optimizing outcomes in this population.
• Further research is needed to establish evidence-based guidelines for thrombolytic therapy in patients >90 years.