Department of Cardiology, University Hospital Monklands, Airdrie ML6 0JS, UK, Email:
General Medicine, Inverclyde Royal Hospital, Glasgow, UK.
J R Coll Physicians Edinb. 2021 Mar;51(1):13-18. doi: 10.4997/JRCPE.2021.105.
Primary percutaneous coronary intervention (PPCI) is the first-line treatment for acute ST-elevation myocardial infarction (STEMI). Evidence of benefit from PPCI in the elderly is sparse. Our aim was to evaluate survival outcomes in patients aged ≥85 years who undergo PPCI for STEMI.
Clinical data were collected retrospectively on all patients aged ≥85 years who were referred and accepted for PPCI to our centre between 2013 and 2018.
One hundred and forty-three patients received PPCI. Median hospital stay was seven days. One hundred and thirty-one patients survived admission. One-year mortality was 33.5%. Age and baseline renal function were independent predictors of one-year mortality. Median survival was 2.55 years.
Advanced age alone should not be used as an exclusion criterion for PPCI; rather, a personalised approach that takes into account all clinically relevant patient factors should guide PCI decision-making. Our findings suggest that PPCI as first-line treatment for STEMI in the very old should be considered routinely.
经皮冠状动脉介入治疗（PPCI）是急性 ST 段抬高型心肌梗死（STEMI）的首选治疗方法。老年人接受 PPCI 治疗的益处证据很少。我们的目的是评估年龄≥85 岁接受 PPCI 治疗 STEMI 的患者的生存结局。
回顾性收集了 2013 年至 2018 年期间所有年龄≥85 岁并被转诊至我们中心接受 PPCI 的患者的临床数据。
143 名患者接受了 PPCI。中位住院时间为 7 天。131 名患者存活入院。1 年死亡率为 33.5%。年龄和基线肾功能是 1 年死亡率的独立预测因素。中位生存时间为 2.55 年。
单纯年龄较大不应作为 PPCI 的排除标准；相反，应根据所有临床相关患者因素采取个体化方法来指导 PCI 决策。我们的研究结果表明，对于非常高龄的 STEMI 患者，应常规考虑将 PPCI 作为一线治疗方法。
