Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Heart. 2010 Jun;96(11):843-7. doi: 10.1136/hrt.2009.185678. Epub 2009 Dec 4.
The general population is gradually ageing in the western world. Therefore, the number of octogenarians undergoing primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) is increasing. We aim to provide insight into temporal trends in the annual proportions of octogenarians among STEMI patients undergoing primary PCI and their clinical characteristics and outcomes over an 11-year observational period.
Single-centre observational study.
Between 1997 and 2007, 4506 STEMI patients were treated with primary PCI at the authors' institution. Patients aged over 80 years were identified.
Temporal trends in the annual proportion of octogenarian STEMI patients and their baseline characteristics, 30-day and 1-year mortality were analysed.
A total of 379 octogenarians (8.4% of the total population) was treated with primary PCI between 1997 and 2007. Over time, the annual proportion of octogenarians gradually increased from four of 113 (3.5%) in 1997 to 51 of 579 (8.8%) in 2007 (p for trend <0.01). In the total cohort of 379 patients, 30-day mortality was 21% (81 patients) and 1-year mortality was 28% (107 patients). There was no improvement in survival among octogenarian STEMI patients over the 11-year study period.
The annual proportion of octogenarian STEMI patients increased significantly over the 11-year study period. Mortality among these high-risk patients was high and did not improve during the study period. Unfortunately, little is known about the optimal treatment of the elderly as they are underrepresented in many randomised clinical trials. Further studies into the optimal STEMI management strategy for the elderly are warranted.
在西方世界，总人口正逐渐老龄化。因此，接受经皮冠状动脉介入治疗（PCI）治疗 ST 段抬高型心肌梗死（STEMI）的 80 岁以上患者数量正在增加。我们旨在提供有关在 11 年观察期内接受直接 PCI 的 STEMI 患者中 80 岁以上患者的年度比例及其临床特征和结局的时间趋势的深入了解。
单中心观察性研究。
1997 年至 2007 年间，作者所在机构对 4506 例 STEMI 患者进行了直接 PCI 治疗。确定了年龄超过 80 岁的患者。
分析 80 岁以上 STEMI 患者的年度比例及其基线特征、30 天和 1 年死亡率的时间趋势。
1997 年至 2007 年间，共有 379 例 80 岁以上患者接受了直接 PCI 治疗。随着时间的推移，80 岁以上患者的年度比例逐渐从 1997 年的 113 例中的 4 例（3.5%）增加到 2007 年的 579 例中的 51 例（8.8%）（趋势检验，p<0.01）。在 379 例患者的总队列中，30 天死亡率为 21%（81 例），1 年死亡率为 28%（107 例）。在 11 年的研究期间，80 岁以上 STEMI 患者的生存率没有改善。
在 11 年的研究期间，80 岁以上 STEMI 患者的年度比例显著增加。这些高危患者的死亡率很高，在研究期间没有改善。不幸的是，由于他们在许多随机临床试验中的代表性不足，对老年人的最佳治疗方法知之甚少。需要进一步研究老年人 STEMI 的最佳管理策略。
