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Coronary intervention in patients ≥75 years old with ST-elevation myocardial infarction: in-hospital and 6-month clinical outcomes

摘要:

Background ST-segment elevation myocardial infarction (STEMI) in elderly patients presents specific clinical characteristics.The study on percutaneous coronary intervention (PCI) in elderly patients (≥75 years) with STEMI,however, has less been performed.Methods In the present study, 522 consecutive STEMI patients undergoing PCI within 12 hours from symptom onset were investigated, and clinical characteristics and in-hospital and 6-month outcomes of 66 elderly patients (≥75 years,group A) were compared to those of 456 younger patients (<75 years, group B).Results Compared to younger patients, elderly ones had more females (42.4% vs.17.8%, P <0.005), a history of cerebral vascular events (7.6% vs.0.9%, P <0.05), higher serum creatinine level ((96.48±31.65) mmol/L vs.(84.87±19.81)mmol/L, P<0.005) and fewer smokers (28.8% vs.45.4%, P<0.05).The elderly ones had worse Killip class (Killip I class:69.7% vs.85.7%, P <0.05), less drug-eluting stent implantation and lower rates of TIMI flow 3 following PCI (33.3% vs.47.1%, and 84.8% vs.94.7%, P <0.05 respectively).Additionally, both in-hospital mortality and myocardial infarction rate were found to be higher in elderly patients (16.7% vs.1.5%, and 7.6% vs.2.6%, P <0.05 respectively), which were also observed until 6-month follow-up (9.1% vs.0, and 6.1% vs.0, P <0.05 respectively=.In multivariable Cox regression analysis, serum creatinine level, history of hypertension, left anterior descending coronary artery as infarct-related artery and Killip class were independent predictors of 6-month overall death in elderly patients.Conclusions The clinical characteristics of elderly patients with STEMI after PCI are different from those of younger patients.Although PCI in this population is with a low rate of PCI failure, it is still associated with a worse outcome.

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作者单位: Department of Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China [1]
期刊: 《中华医学杂志(英文版)》2010年123卷16期 2171-2175页 SCISCIEMEDLINEISTICCSCDCABP
分类号: R5
DOI: 10.3760/cma.j.issn.0366-6999.2010.16.002
发布时间: 2010-09-10
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