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.
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.
