BACKGROUND: Improvements in life expectancy of the overall population and the risk of bleeding with thrombolytics have enabled very elderly patients with acute myocardial infarction to be treated by primary percutaneous coronary intervention (PCI). We analyzed the primary PCI in-hospital results in patients > 80 years of age. METHOD: From January 2002 to October 2008, 4,788 PCIs were performed, of which 428 were primary PCIs. Of these, 34 were performed in patients > 80 years of age and 394 in patients < 80 years of age. RESULTS: Females (47.1% vs. 27.7%; P = 0.017), Killip IV functional class (11.8% vs. 4.1%; P = 0.002) and pre-procedure TIMI 2/3 flow (60% vs. 44.4%; P = 0.032) were more frequent in elderly patients. Smoking (44.9% vs. 8%; P < 0.001) and use of glycoprotein IIb/IIIa inhibitors (32.5% vs. 11.7%; P = 0.04) were prevalent in the group < 80 years of age. There were no significant differences for door-to-balloon time (117.4 ± 125.7 minutes vs. 179.3 ± 169.8 minutes; P = 0.095), use of stents (91.2% vs. 98.2%; P = 0.78), or drug-eluting stents (0 vs. 2.8%; P = 0.067) and thrombus aspiration devices (11.7% vs. 12.2%; P = 0.65). Angiographic success rate was equal between the groups (97.1% vs. 96.5%; P > 0.99), but patients > 80 years old had a higher mortality rate (11.8% vs. 2.3%; P = 0.014). Reinfarction, stroke, major vascular complications and acute renal failure were similar between groups. CONCLUSION: PCI usually presents high angiographic success and low complication rates, reinforcing its role as a method of choice for reperfusion in the acute phase of myocardial infarction. Very elderly patients (> 80 years of age) have higher mortality rates, possibly due to the greater comorbidity in this group.
Angioplasty, transluminal, percutaneous coronary; Aged, 80 and over; Myocardial infarction
