Oh Seok, Jeong Myung Ho, Cho Kyung Hoon, Kim Min Chul, Sim Doo Sun, Hong Young Joon, Kim Ju Han, Ahn Youngkeun
Department of Cardiology, Chonnam National University Hospital, Gwangju 61469, Korea.
Department of Cardiology, Chonnam National University Medical School, Hwasun 58128, Korea.
J Clin Med. 2022 Mar 14;11(6):1593. doi: 10.3390/jcm11061593.
Percutaneous coronary intervention (PCI) is the mainstay treatment of acute myocardial infarction (AMI); however, many clinicians are reluctant to perform PCI in the elderly population. This study aimed to compare the clinical outcomes of PCI versus medical therapy in nonagenarian Korean patients with AMI. We compared the clinical outcomes of nonagenarian patients with AMI with or without PCI. From the pooled data, based on a series of Korean AMI registries during 2005−2020, 467 consecutive patients were selected and categorized into two groups: the PCI and no-PCI groups. The primary endpoint was 1-year major adverse cardiac event (MACE), a composite of all-cause death, non-fatal myocardial infarction, and any revascularization. Among the 467 participants, 68.5% received PCI. The PCI group had lower proportions of Killip classes III-IV, previous heart failure, and left ventricular ejection fraction <40%, but had higher proportions of all prescribed medications and STEMI diagnosis. The 1-year MACE and all-cause death were higher in the no-PCI group, although partially attenuated post-IPTW. Our study showed that nonagenarian patients with AMI undergoing PCI had better clinical outcomes than those without PCI. Nonetheless, further investigation is needed in the future to elucidate whether PCI is beneficial for this population.
经皮冠状动脉介入治疗（PCI）是急性心肌梗死（AMI）的主要治疗方法；然而，许多临床医生不愿对老年人群进行PCI治疗。本研究旨在比较韩国非agenarian（九旬老人）AMI患者接受PCI与药物治疗的临床结局。我们比较了接受或未接受PCI的非agenarian AMI患者的临床结局。从2005年至2020年期间一系列韩国AMI登记处的汇总数据中，选择了467例连续患者并分为两组：PCI组和非PCI组。主要终点是1年主要不良心脏事件（MACE），它是全因死亡、非致命性心肌梗死和任何血运重建的综合指标。在467名参与者中，68.5%接受了PCI治疗。PCI组中Killip III-IV级、既往心力衰竭和左心室射血分数<40%的比例较低，但所有处方药的比例和STEMI诊断比例较高。非PCI组的1年MACE和全因死亡率较高，尽管在倾向评分加权后有所降低。我们的研究表明，接受PCI治疗的非agenarian AMI患者比未接受PCI治疗的患者具有更好的临床结局。尽管如此，未来仍需要进一步研究以阐明PCI对该人群是否有益。
