Document Detail

Outcomes after primary percutaneous coronary intervention in octogenarians and nonagenarians with ST segment elevation myocardial infarction from the western denmark heart registry.
MedLine Citation:
PMID:  22887706     Owner:  NLM     Status:  Publisher    
BACKGROUND: Elderly patients with ST-segment elevation myocardial infarction (STEMI) constitute a particular risk group in relation to primary percutaneous coronary intervention (PPCI). OBJECTIVE: We examined the proportion of octogenarians and nonagenarians undergoing PPCI in Western Denmark, and their short- and long-term mortality rates. METHODS: From 2002 to 2009 all consecutive patients ≥80 years with STEMI treated with PPCI were identified in the population based Western Denmark Heart Registry. Cox regression analysis was used to compute hazard ratios, controlling for potential confounding. RESULTS: A total of 1,322 elderly (1,213 octogenarians and 109 nonagenarians), corresponding to 11.6% of the total PPCI treated STEMI population, were treated with PPCI between 2002 and 2009. The annual proportion of octogenarians referred for PPCI increased from n=52 (6.2%) in 2002 to n=172 (11.8%) in 2009 (p<0.01), while it remained unchanged in nonagenarians: n=6 (0.6%) in 2002 to n=13 (0.8%) in 2009 (p=ns). For octogenarians and nonagenarians 30-day mortality was 17.2% vs. 25.8% (log rank p=0.028), 1-year mortality was 27.6% vs. 32.5% (log rank p=0.18) and 5-year mortality 53.6% vs. 57.3% (log-rank p=0.087), respectively. Adjusted 30-day HR=1.59 (95% confidence interval=CI 1.07-2.36), 1-year HR=1.34 (CI 0.95-1.90) and 5-year mortality HR=1.39 (CI 1.04-1.85), was higher in nonagenarians compared to octogenarians. CONCLUSION: The annual proportion of octogenarians with STEMI treated with PPCI doubled from 2002 to 2009, while the proportion of nonagenarians remained unchanged. Although nonagenarians had the highest short- and long-term mortality, we found the outcome acceptable with a 5-year survival of more than 40% in both groups. © 2012 Wiley Periodicals, Inc.
Lisbeth Antonsen; Lisette Okkels Jensen; Christian Juhl Terkelsen; Hans-Henrik Tilsted; Anders Junker; Michael Maeng; Knud Noerregaard Hansen; Jens Flensted Lassen; Leif Thuesen; Per Thayssen
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-6
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  -     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Wiley Periodicals, Inc.
Department of Cardiology, Odense University Hospital, Odense, Denmark.
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