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Temporal trends and in-hospital outcomes of primary percutaneous coronary intervention in nonagenarians with ST-segment elevation myocardial infarction

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Affiliated Author(s)
허승호
Alternative Author(s)
Hur, Seung Ho
Journal Title
Korean Journal of Internal Medicine
ISSN
1226-3303
Issued Date
2015
Keyword
In-hospital outcomesAged, 90 and overMyocardial infarctionPercutaneous coronary intervention
Abstract
Background/Aims: Data regarding the outcomes of primary percutaneous coronary
intervention (PCI) for ST-segment elevation myocardial infarction (STEMI)
in nonagenarians are very limited. The aim of the present study was to evaluate
the temporal trends and in-hospital outcomes of primary PCI in nonagenarian
STEMI patients.
Methods: We retrospectively reviewed data from the Korea Acute Myocardial Infarction
Registry (KAMIR) from November 2005 to January 2008, and from the
Korea Working Group on Myocardial Infarction (KorMI) from February 2008 to
May 2010.
Results: During this period, the proportion of nonagenarians among STEMI
patients more than doubled (0.59% in KAMIR vs. 1.35% in KorMI), and the rate of
use of primary PCI also increased (from 62.5% in KAMIR to 81.0% in KorMI). We
identified 84 eligible study patients for which the overall in-hospital mortality
rate was 21.4% (25.0% in KAMIR vs. 20.3% in KorMI, p = 0.919). Multivariate analysis
identified two independent predictors of in-hospital mortality, namely a final
Thrombolysis in Myocardial Infarction (TIMI) flow < 3 (odds ratio [OR], 13.7; 95%
confidence interval [CI], 3.2 to 59.0; p < 0.001) and cardiogenic shock during hospitalization
(OR, 6.7; 95% CI, 1.5 to 30.3; p = 0.013).
Conclusions: The number of nonagenarian STEMI patients who have undergone
primary PCI has increased. Although a final TIMI flow < 3 and cardiogenic shock
are independent predictors of in-hospital mortality, primary PCI can be performed
with a high success rate and an acceptable in-hospital mortality rate.
Department
Dept. of Internal Medicine (내과학)
Publisher
School of Medicine
Citation
Joon Young Kim et al. (2015). Temporal trends and in-hospital outcomes of primary percutaneous coronary intervention in nonagenarians with ST-segment elevation myocardial infarction. Korean Journal of Internal Medicine, 30(6), 821–828. doi: 10.3904/kjim.2015.30.6.821
Type
Article
ISSN
1226-3303
DOI
10.3904/kjim.2015.30.6.821
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33052
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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