Predictors of in-hospital mortality in octogenarian patients who underwent primary percutaneous coronary intervention after ST segment elevated myocardial infarction.

Autor: Ipek G; Siyami Ersek Cardiothoracic Surgery Center, Department of Cardiology, Istanbul, Turkey., Kurmus O; Ataturk Training and Research Hospital, Department of Cardiology, Ankara, Turkey., Koseoglu C; Ataturk Training and Research Hospital, Department of Cardiology, Ankara, Turkey., Onuk T; Siyami Ersek Cardiothoracic Surgery Center, Department of Cardiology, Istanbul, Turkey., Gungor B; Siyami Ersek Cardiothoracic Surgery Center, Department of Cardiology, Istanbul, Turkey., Kirbas O; Ataturk Training and Research Hospital, Department of Cardiology, Ankara, Turkey., Karatas MB; Siyami Ersek Cardiothoracic Surgery Center, Department of Cardiology, Istanbul, Turkey., Keskin M; Siyami Ersek Cardiothoracic Surgery Center, Department of Cardiology, Istanbul, Turkey., Betul Borklu E; Siyami Ersek Cardiothoracic Surgery Center, Department of Cardiology, Istanbul, Turkey., Hayiroglu MI; Siyami Ersek Cardiothoracic Surgery Center, Department of Cardiology, Istanbul, Turkey., Tanik O; Siyami Ersek Cardiothoracic Surgery Center, Department of Cardiology, Istanbul, Turkey., Oz A; Siyami Ersek Cardiothoracic Surgery Center, Department of Cardiology, Istanbul, Turkey., Bolca O; Siyami Ersek Cardiothoracic Surgery Center, Department of Cardiology, Istanbul, Turkey.
Jazyk: angličtina
Zdroj: Geriatrics & gerontology international [Geriatr Gerontol Int] 2017 Apr; Vol. 17 (4), pp. 584-590. Date of Electronic Publication: 2016 Apr 18.
DOI: 10.1111/ggi.12759
Abstrakt: Aim: Octogenarian patients have higher mortality and morbidity rates after acute coronary syndromes. Risk factors for in-hospital mortality in the primary percutaneous coronary intervention (PCI) era were underrepresented in previous studies. In the present study, we aimed to assess the risk factors of in-hospital mortality after primary PCI in this population.
Methods: We analyzed 2353 patients who underwent primary PCI after ST segment elevated myocardial infarction (STEMI). Patients were divided into two groups according to aged: ≥80 years (octogenarian) and <80 years (control). Risk factors for in-hospital mortality were analyzed in the whole group and octogenarian patients.
Results: We found that octogenarians have 10.6-fold higher mortality risk after STEMI. After a univariate and multivariate analysis, acute stent thrombosis was the most explicit risk factor for in-hospital mortality in the octogenarian group (OR 21.13, 95% CI 2.11-102.76, P < 0.001). Additionally, anterior myocardial infarction (OR 4.90, 95% CI 1.90-22.10, P = 0.04), ventricular arrhythmias (OR 15.64, 95% CI 2.81-87.12, P = 0.002), multivessel disease (OR 6.5, 95% CI 1.11-38.85, P = 0.04), ejection fraction <30% (OR 1.24, 95% CI 0.26-6.00, P = 0.04) and KILLIP score ≥2 (OR 1.20, 95% CI 0.20- 7.41, P = 0.01) were also significantly associated with mortality.
Conclusions: Acute stent thrombosis, anterior MI, heart failure, low ejection fraction, ventricular arrhythmias and multivessel disease are the independent risk factors for in-hospital mortality among octogenarian patients after primary PCI. Geriatr Gerontol Int 2017; 17: 584-590.
(© 2016 Japan Geriatrics Society.)
Databáze: MEDLINE
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