Comparison of Functional Recovery Following Percutaneous Coronary Intervention for ST Elevation Myocardial Infarction in Three Age Groups (<70, 70 to 79, and ≥80 Years)

• Published in: The American journal of cardiology 2013-08, Vol.112 (3), p.330-335
• Main Authors: Christiansen, Ellen C., MD, Wickstrom, Kelly K., BA, Henry, Timothy D., MD, Garberich, Ross F., MS, Rutten-Ramos, Stephanie C., PhD, Larson, David M., MD, Grey, Elizabeth Z., MD, Thiessen, Norma L., MD, Hauser, Robert G., MD, Newell, Marc C., MD
• Format: Article
• Language: English
• Subjects: Activities of Daily Living - classification; Activities of Daily Living - psychology; Age Factors; Aged; Aged, 80 and over; Angioplasty, Balloon, Coronary - mortality; Angioplasty, Balloon, Coronary - psychology; Anticoagulants - administration & dosage; Assisted living facilities; Bundle-Branch Block - mortality; Bundle-Branch Block - psychology; Bundle-Branch Block - therapy; Cardiology; Cardiovascular; Cardiovascular disease; Cause of Death; Female; Heart attacks; Hospital Mortality; Humans; Kaplan-Meier Estimate; Length of Stay - statistics & numerical data; Male; Minnesota; Mortality; Myocardial Infarction - mortality; Myocardial Infarction - psychology; Myocardial Infarction - therapy; Patient Transfer; Prospective Studies; Quality of Life - psychology; Stents; Thrombolytic Therapy
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2013.03.031

Functional outcomes of elderly patients ≥80 years who undergo percutaneous coronary intervention (PCI) for ST elevation myocardial infarction (STEMI) are unknown. Registry data indicate that up to 55% of elderly patients with STEMI do not receive reperfusion therapy despite a suggested mortality benefit, and only limited data are available regarding outcomes in elderly patients treated with primary PCI. Therefore, prospective data from a regional STEMI transfer program were analyzed to determine major adverse cardiac events, length of stay, and discharge status of consecutive patients with STEMI ≥80 years from March 2003 to November 2006. Of the 1,323 consecutive patients with STEMI treated in this regional STEMI system from March 2003 to November 2006, 199 (15.0%) were ≥80 years old. In-hospital mortality in elderly patients was 11.6%, with a 1-year mortality rate of 25.6%. Of the 166 patients with age ≥80 who lived independently or in assisted living before hospital admission and survived, 150 (90.4%) were discharged to a similar living situation or projected to such a living situation after temporary nursing home care. The median length of hospital stay was 4 days for these patients. In conclusion, elderly patients with age ≥80 receiving PCI for STEMI in a regional STEMI program have short hospital stays and excellent functional recovery on the basis of a very high rate of return to a similar previous living situation.