In Hospital and Long Term Outcomes in Very Elderly Patients Treated with Percutaneous Coronary Intervention for ST Segment Elevation Myocardial Infarction

Very elderly individuals (≥ 85 years) constitute an increasing proportion of patients presenting with ST segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). We evaluated the incidence of in-hospital complications and one year outcomes in very elderly STEMI patients treated with primary PCI.

Methods and results: We performed a retrospective analysis of the data of all STEMI patients ≥ 85 years, treated with primary PCI between January 2008 and August 2018. Patients record were assessed for in-hospital complications (in-hospital and 30 day mortality, recurrent MI, acute kidney injury, cardiogenic shock, arrythmias, mechanical ventilation and bleeding complications), long term complications defined as hospitalizations for heart failure, stroke and recurrent myocardial infarction as well as long term mortality.

Results: Study cohort included 145 patients (mean age 88 ± 3 years, 60% men). In hospital mortality was 13% (19/145) and all-cause mortality was 30% (44/145). Other complications occurred in 93/145 (64%) of patients prior to discharge. In one year follow-up, 17/126 (13%) of patients were admitted for recurrent myocardial infarction, 21/126 (17%) for heart failure and 1/126 (1%) for stroke.

Conclusions: Among very elderly STEMI patients undergoing primary PCI, In hospital complications and long term major adverse cardiac events are frequent