Journal of the Practice of Cardiovascular Sciences (Jan 2020)
Primary percutaneous coronary intervention in elderly (age ≥75 years) Indian population – Immediate- and short-term results
Abstract
Background: Primary percutaneous coronary intervention (PCI) is the best reperfusion strategy for patients presenting with ST-segment elevation myocardial infarction (STEMI). Limited data exist on outcomes of primary PCI in elderly patients due to frequent exclusions of this cohort from the trials. The aim of the present study was to evaluate the acute and short-term outcomes of primary PCI in STEMI patients aged ≥75 years. Material and Methods: A total of 50 elderly patients undergoing primary PCI were prospectively enrolled between December 2017 and May 2019. Inhospital and 6-month outcomes of patients were recorded and analyzed. Results: The mean age of the patients was 78.32 ± 3.1 years (range = 75–90 years), and 38.0% were women. Almost half of the patients had triple-vessel disease, and the most common infarct-related artery was left anterior descending artery. Angiographic success was achieved in 78% of the patients, and inhospital mortality rate was 8%. Complete heart block at presentation, Killip Class III, delayed presentation (>6 h), moderate-to-severe left ventricular systolic dysfunction, slow-flow or no-reflow phenomenon, diabetes, and nonresolution of ST segment were major predictors of inhospital mortality. Conclusion: We demonstrate the favorable immediate- and short-term outcomes of primary PCI in elderly patients aged ≥75 years presenting with STEMI and conclude that it can be safely and successfully performed in this population with acceptable rate of complications.
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