The prevalence and outcomes in STEMI patients aged ≥75 undergoing primary percutaneous coronary intervention in China.
Int J Cardiol Cardiovasc Risk Prev
; 21: 200251, 2024 Jun.
Article
en En
| MEDLINE
| ID: mdl-38464698
ABSTRACT
Objective:
To investigate the prevalence and outcomes of primary percutaneous coronary intervention (PCI) in Chinese patients with ST-segment elevation myocardial infarction (STEMI) aged ≥75 years.Methods:
We identified STEMI patients aged ≥75 years between 2013 and 2014 from a multicenter registry. The primary outcome was all-cause mortality. The secondary outcome was major adverse cardiac and cerebrovascular event (MACCE) including a composite of all-cause mortality, cardiac death, recurrent MI, stroke, revascularization, and major bleeding. Hazard ratios (HR) and associated 95% confidence interval (CI) were calculated.Results:
Approximately 32.9% (n = 999) patients received primary PCI. Primary PCI was associated with lower risks of two-year all-cause mortality (18.0% vs. 36.4%; adjusted HR 0.54, 95% CI 0.45 to 0.65, P < 0.0001), MACCE (28.7% vs. 43.5%; adjusted HR 0.68, 95% CI 0.59 to 0.80, P < 0.0001), and cardiac death (10.0% vs. 23.6%; adjusted HR 0.49, 95% CI 0.38 to 0.62, P < 0.0001) relative to no reperfusion (n = 2041) in patients aged ≥75 years. The better outcomes in two-year all-cause mortality, MACCE, and cardiac death were consistently observed in STEMI patients aged ≥85 years. No differences were observed in recurrent MI, stroke, revascularization, and major bleeding between the two groups. Additionally, in patients with relatively high-risk profiles such as cardiogenic shock or delaying hospital admission, primary PCI was also superior to no reperfusion.Conclusion:
Primary PCI may decrease two-year all-cause mortality, MACCE, and cardiac death in STEMI patients aged ≥75 years, even in these with age ≥85 years, cardiogenic shock, or delaying hospital admission. However, primary PCI was underutilized in Chinese clinical practice.
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Banco de datos:
MEDLINE
Idioma:
En
Revista:
Int J Cardiol Cardiovasc Risk Prev
Año:
2024
Tipo del documento:
Article
País de afiliación:
China