Effectiveness and safety of routine primary angioplasty in patients aged ≥85 years with acute myocardial infarction

Background: Although octogenarians constitute a fast growing portion of cardiovascular patients, few data are available on the outcome of very old patients (age >80 years) with ST-segment elevation myocardial infarction (STEMI) undergoing primary angioplasty. Methods and Results: Short- and long-term outcomes of 88 consecutive very old (age ≥85 years) patients with STEMI undergoing primary angioplasty were evaluated. In-hospital mortality was 17%, significantly higher in patients with cardiogenic shock (90%; p12h (p=0.04) as independent predictors of mortality at long-term follow-up. Conclusions: The low incidence of procedural complications, together with good long term survival, suggest that primary PCI in STEMI patients ≥85 years is safe and efficacious, with a low rate of PCI failure in the presence of a low Killip class on admission, whereas primary PCI is unable to affect the poor prognosis for very old patients with cardiogenic shock.