Old Age and Outcome After Primary Angioplasty for Acute Myocardial Infarction

• Published in: Journal of the American Geriatrics Society (JAGS) Vol. 58; no. 5; pp. 867 - 872
• Main Authors: de Boer, Menko-Jan, Ottervanger, Jan Paul, Suryapranata, Harry, Hoorntje, Jan C.A., Dambrink, Jan-Henk E., Gosselink, A.T. Marcel, van't Hof, Arnoud W.J., Zijlstra, Felix
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01-05-2010; Wiley-Blackwell; Wiley Subscription Services, Inc
• Subjects: Age; Age Factors; Aged; Angioplasty; Angioplasty, Balloon, Coronary; Biological and medical sciences; Cardiology. Vascular system; Coronary heart disease; Diseases of the cardiovascular system; elderly; Female; General aspects; Heart; Heart attacks; Humans; Male; Medical sciences; Middle Aged; Mortality; myocardial infarction; Myocardial Infarction - mortality; Myocardial Infarction - surgery; primary angioplasty; Prognosis; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Retrospective Studies; Risk factors; Treatment Outcome; Netherlands; Human; Myocardial infarction; Prognosis; Angioplasty; Acute; Instrumentation therapy; Cardiovascular disease; Instrumental dilatation; primary angioplasty; Coronary heart disease; Myocardial disease; Gerontology; Primary; Evolution; Elderly; Geriatrics
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/j.1532-5415.2010.02821.x

OBJECTIVES: To assess the influence of age as an independent factor determining the prognosis and outcome of patients with acute myocardial infarction (AMI) treated using primary percutaneous coronary intervention (PCI).
DESIGN: A retrospective analysis from a dedicated database.
SETTING: A high‐volume interventional cardiology center in the Netherlands.
PARTICIPANTS: Four thousand nine hundred thirty‐three consecutive patients with AMI.
MEASUREMENTS: Baseline characteristics and clinical outcomes after 30 days and 1 year were compared according to age categorized in three groups: younger than 65, 65 to 74, and 75 and older. A more‐detailed analysis was performed with six age groups, from younger than 40 to 80 and older.
RESULTS: Of the 4,933 consecutive patients with AMI treated with PCI between 1992 and 2004, 643 were aged 75 and older. Multivariate analysis revealed that patients aged 65 to 75 had a greater risk of 1‐year mortality than those younger than 65 (adjusted odds ratio (AOR)=1.57, 95% confidence interval (CI)=1.15–2.16) and that those aged 75 and older had a greater risk of 1‐year mortality than those younger than 65 (AOR=3.03, 95% CI=2.14–4.29).
CONCLUSION: In this retrospective analysis, older age was independently associated with greater mortality after PCI for AMI. Patients aged 65 and older had a higher risk of mortality than younger patients, and those aged 75 and older had the highest risk of mortality.