Su Ya-Min, Cai Xing-Xing, Geng Hai-Hua, Sheng Hong-Zhuan, Fan Meng-Kan, Pan Min
Department of Cardiology, Affiliated Hospital of Nantong University Nantong 226001, P. R. China.
Int J Clin Exp Med. 2015 Jul 15;8(7):11244-51. eCollection 2015.
Elderly patients are at high risk of mortality when they present with ST-elevation myocardial infarction (STEMI). However, the clinical outcomes of this sub-group undergoing primary percutaneous coronary intervention (PPCI) have not been well established, despite recent advances in both devices and techniques. In the present retrospective cohort study from a Chinese single center, we assessed the clinical outcomes and predictors of mortality in elderly patients (≥60 years) underwent with PPCI. The primary endpoints were immediate angiographic success and in-hospital procedural success. The secondary endpoints were all-cause death in hospital. Between January 2011 and December 2013, a total of 184 consecutive patients with acute STEMI underwent PPCI were enrolled. 116 (63.04%) patients were in the elderly group. Despite the difference in lesion complexity between groups, the immediate angiographic success rate was similar (93.97% in the elderly group, and 94.12% in the non-elderly group, P=0.966). The procedural success rate were not significantly different between the two groups (90.52% in the elderly group, and 94.12% in the non-elderly group, P=0.389). However, in-hospital mortality was statistically higher in elderly group than in the non-elderly group (8.62% Vs 1.47%, P=0.048). The major causes of death were cardiac shock and malignant arrhythmias (ventricular tachycardia and fibrillation). Our results indicate that PPCI in the elderly is feasible and has a high likelihood of immediate angiographic and procedural success.
老年患者出现ST段抬高型心肌梗死(STEMI)时死亡风险很高。然而,尽管在设备和技术方面都有了最新进展,但这一亚组患者接受直接经皮冠状动脉介入治疗(PPCI)的临床结果尚未完全明确。在这项来自中国单中心的回顾性队列研究中,我们评估了接受PPCI的老年患者(≥60岁)的临床结果和死亡预测因素。主要终点是即刻血管造影成功和院内手术成功。次要终点是院内全因死亡。在2011年1月至2013年12月期间,共有184例连续的急性STEMI患者接受了PPCI并被纳入研究。116例(63.04%)患者属于老年组。尽管两组病变复杂性存在差异,但即刻血管造影成功率相似(老年组为93.97%,非老年组为94.12%,P = 0.966)。两组的手术成功率无显著差异(老年组为90.52%,非老年组为94.12%,P = 0.389)。然而,老年组的院内死亡率在统计学上高于非老年组(8.62%对1.47%,P = 0.048)。主要死亡原因是心源性休克和恶性心律失常(室性心动过速和颤动)。我们的结果表明,老年患者的PPCI是可行的,并且即刻血管造影和手术成功的可能性很高。