Incidence And Predictors Of Mortality In Very Elderly Patients With St-Segment Elevation Acute Myocardial Infarction Undergoing Primary Angioplasty

The primary percutaneous coronary intervention (PPCI) is the preferred therapy for the ST-segment elevation acute myocardial infarction (STEMI) in the general population and nowadays is performed more often in the population of very elderly patients despite the high risk of complications and mortality. From January 2006 to January 2010, we performed 1,534 PPCI, being 356 (23.2%) in patients older than 75 years. Procedural success rate was achieved in the 90% of patients, with 1 or 2 stents implanted in the 81%. Mean age was 80 years, 53% were male and 8.4% were in Killip class III-IV. Thirty-day all-cause mortality occurred 17.4% and 1-year mortality in 4%. Patient age (RR 1.153 [95% CI 1.056-1.260]), Killip class III-IV (RR 3.084 [95% CI 2.047-4.646]), post-PPCI TIMI flow grade (RR 0.339 [95% CI 0.163-0.705]) were identified as independent predictors of 30-day mortality and at 1-year mortality only the family history of coronary heart disease (RR 9.040 [95% CI 2.415-33.837]).