Percutaneous Coronary Intervention for Acute Myocardial Infarction in Elderly Patients with Renal Dysfunction: Results from the Korea Acute Myocardial Infarction Registry.
10.3346/jkms.2013.28.7.1027
- Author:
Sang Yup LIM
1
;
Eun Hui BAE
;
Joon Seok CHOI
;
Chang Seong KIM
;
Seong Kwon MA
;
Youngkeun AHN
;
Myung Ho JEONG
;
Weon KIM
;
Jong Shin WOO
;
Young Jo KIM
;
Myeong Chan CHO
;
Chong Jin KIM
;
Soo Wan KIM
Author Information
1. Department of Internal Medicine, Korea University, Ansan, Korea.
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Acute Myocardial Infarction;
Renal Dysfunction;
Elderly;
Percutaneous Coronary Intervention;
Major Adverse Cardiac Event
- MeSH:
Aged;
Aged, 80 and over;
Aging;
Creatinine/blood;
Female;
Humans;
Male;
Myocardial Infarction/*mortality/*therapy;
Percutaneous Coronary Intervention/*methods;
Registries;
Renal Insufficiency/*complications;
Republic of Korea;
Survival Rate;
Treatment Outcome
- From:Journal of Korean Medical Science
2013;28(7):1027-1033
- CountryRepublic of Korea
- Language:English
-
Abstract:
This study aimed to evaluate the effects of percutaneous coronary intervention (PCI) on short- and long-term major adverse cardiac events (MACE) in elderly (>75 yr old) acute myocardial infarction (AMI) patients with renal dysfunction. As part of Korea AMI Registry (KAMIR), elderly patients with AMI and renal dysfunction (GFR<60 mL/min) received either medical (n=439) or PCI (n=1,019) therapy. Primary end point was in-hospital death. Secondary end point was MACE during a 1 month and 1 yr follow-up. PCI group showed a significantly lower incidence of in-hospital death (20.0% vs 14.3%, P=0.006). Short-term and long-term MACE rates were higher in medical therapy group (31.9% vs 19.0%; 57.7% vs 31.3%, P<0.001), and this difference was mainly attributed to cardiac death (29.3% vs 17.6%; 51.9% vs 25.0%, P<0.001). MACE-free survival time after adjustment was also higher in PCI group on short-term (hazard ratio, 0.67; confidence interval, 0.45-0.98; P=0.037) and long-term follow-up (hazard ratio, 0.61, confidence interval, 0.45-0.83; P=0.002). In elderly AMI patients with renal dysfunction, PCI therapy yields favorable in-hospital and short-term and long-term MACE-free survival.
