Elderly suffering from st-segment elevation myocardial infarction—results from a database analysis from two mediterranean medical centers

Leor Perl, Alfonso Franzé, Fabrizio D’ascenzo, Noa Golomb, Amos Levi, Hana Vaknin-Assa, Gabriel Greenberg, Abid Assali, Gaetano M. De Ferrari, Ran Kornowski

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Little is known regarding primary percutaneous coronary intervention (pPCI) for ST-segment elevation myocardial infarction (STEMI) in the elderly. Methods: Data on 319 octogenarians, 641 septuagenarians, and 2451 younger patients was collected from an ongoing prospective registry of patients treated with pPCI for STEMI at two Mediterranean-area medical centers in 2009–2017. Results: More octogenarian patients were female (40.8 vs. 31.9 septuagenarians and 26.5% under 70 y, p < 0.01), had hypertension (79.5 vs. 69.5 and 45.9%, p < 0.01), renal failure (32.5 vs. 20.1 and 5.2%, p < 0.01), and a lower left-ventricular ejection fraction (42.0 vs. 44.9 and 47.6%, p = 0.012). At 1 month and 3 years after intervention, mortality was higher in the octogenarian patients (12.2 vs. 7.9%, p = 0.01; and 36.7 vs. 23.1%, p < 0.01, respectively), with no significant differences in the rates of recurrent myocardial infarction, target vessel revascularization, coronary artery bypass surgery, and cardiovascular death. Following adjustment for confounders, 3-year mortality was significantly higher in the octogenarians (HR 3.89 vs. 3.19 for septuagenarians, p < 0.01), but rates of major adverse cardiac events or cardiovascular death were not. Conclusions: Despite suffering from higher all-cause mortality, octogenarian patients treated with pPCI for STEMI do not suffer an increased risk of ischemic cardiac events relative to younger patients.

Original languageEnglish
Article number2435
JournalJournal of Clinical Medicine
Volume10
Issue number11
DOIs
Publication statusPublished - Jun 1 2021

Keywords

  • Elderly
  • Myocardial infarction
  • Octogenarians

ASJC Scopus subject areas

  • Medicine(all)

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