Characteristics, In-Hospital and Long-Term Clinical Outcomes of Nonagenarian Compared with Octogenarian Acute Myocardial Infarction Patients.
10.3346/jkms.2014.29.4.527
- Author:
Ki Hong LEE
1
;
Youngkeun AHN
;
Sung Soo KIM
;
Si Hyun RHEW
;
Young Wook JEONG
;
Soo Young JANG
;
Jae Yeong CHO
;
Hae Chang JEONG
;
Keun Ho PARK
;
Nam Sik YOON
;
Doo Sun SIM
;
Hyun Joo YOON
;
Kye Hun KIM
;
Young Joon HONG
;
Hyung Wook PARK
;
Ju Han KIM
;
Jeong Gwan CHO
;
Jong Chun PARK
;
Myung Ho JEONG
;
Myeong Chan CHO
;
Chong Jin KIM
;
Young Jo KIM
Author Information
1. Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea. cecilyk@hanmail.net
- Publication Type:Original Article ; Comparative Study ; Research Support, Non-U.S. Gov't
- Keywords:
Aged, Eighty and over;
Myocardial Infarction;
Percutaneous Coronary Intervention
- MeSH:
Acute Disease;
Age Factors;
Aged, 80 and over;
*Angioplasty, Balloon, Coronary;
Electrocardiography;
Female;
Hospital Mortality;
Humans;
Male;
Myocardial Infarction/*diagnosis/mortality/therapy;
*Percutaneous Coronary Intervention;
Proportional Hazards Models;
Registries;
Treatment Outcome
- From:Journal of Korean Medical Science
2014;29(4):527-535
- CountryRepublic of Korea
- Language:English
-
Abstract:
We compared clinical characteristics, management, and clinical outcomes of nonagenarian acute myocardial infarction (AMI) patients (n=270, 92.3+/-2.3 yr old) with octogenarian AMI patients (n=2,145, 83.5+/-2.7 yr old) enrolled in Korean AMI Registry (KAMIR). Nonagenarians were less likely to have hypertension, diabetes and less likely to be prescribed with beta-blockers, statins, and glycoprotein IIb/IIIa inhibitors compared with octogenarians. Although percutaneous coronary intervention (PCI) was preferred in octogenarians than nonagenarians, the success rate of PCI between the two groups was comparable. In-hospital mortality, the composite of in-hospital adverse outcomes and one year mortality were higher in nonagenarians than in octogenarians. However, the composite of the one year major adverse cardiac events (MACEs) was comparable between the two groups without differences in MI or re-PCI rate. PCI improved 1-yr mortality (adjusted hazard ratio [HR], 0.50; 95% confidence interval [CI], 0.36-0.69, P<0.001) and MACEs (adjusted HR, 0.47; 95% CI, 0.37-0.61, P<0.001) without significant complications both in nonagenarians and octogenarians. In conclusion, nonagenarians had similar 1-yr MACEs rates despite of higher in-hospital and 1-yr mortality compared with octogenarian AMI patients. PCI in nonagenarian AMI patients was associated to better 1-yr clinical outcomes.
