Primary percutaneous coronary intervention in patients aged 85 years or older: a retrospective analysis of outcomes
Lousie Aubiniere-Robb1, George Reid2, Aengus Murphy3
1Department of Cardiology, University Hospital Monklands, Airdrie ML6 0JS, UK,
Insights
Primary percutaneous coronary intervention (PPCI) offers survival benefits for elderly patients with ST-elevation myocardial infarction (STEMI). Advanced age should not exclude patients from PPCI, supporting a personalized treatment approach.
Area of Science:
- Cardiology
- Geriatric Medicine
- Interventional Cardiology
Background:
- Primary percutaneous coronary intervention (PPCI) is standard for ST-elevation myocardial infarction (STEMI).
- Limited evidence exists on PPCI benefits in elderly populations (≥85 years).
Purpose of the Study:
- To evaluate survival outcomes in patients aged 85 and older undergoing PPCI for STEMI.
Main Methods:
- Retrospective analysis of clinical data from patients ≥85 years referred for PPCI (2013-2018).
Main Results:
- 143 patients underwent PPCI; 131 survived admission with a median hospital stay of 7 days.
- One-year mortality was 33.5%, with age and renal function predicting mortality.
- Median survival reached 2.55 years.
Conclusions:
- PPCI should be considered routinely for very elderly patients with STEMI.
- Personalized assessment, not age alone, should guide PPCI decisions in older adults.
Background:
Primary percutaneous coronary intervention (PPCI) is the first-line treatment for acute ST-elevation myocardial infarction (STEMI). Evidence of benefit from PPCI in the elderly is sparse. Our aim was to evaluate survival outcomes in patients aged ≥85 years who undergo PPCI for STEMI.
Methods:
Clinical data were collected retrospectively on all patients aged ≥85 years who were referred and accepted for PPCI to our centre between 2013 and 2018.
Results:
One hundred and forty-three patients received PPCI. Median hospital stay was seven days. One hundred and thirty-one patients survived admission. One-year mortality was 33.5%. Age and baseline renal function were independent predictors of one-year mortality. Median survival was 2.55 years.
Conclusion:
Advanced age alone should not be used as an exclusion criterion for PPCI; rather, a personalised approach that takes into account all clinically relevant patient factors should guide PCI decision-making. Our findings suggest that PPCI as first-line treatment for STEMI in the very old should be considered routinely.
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