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Background: ST elevation myocardial infarction in nonagenarians is associated with high mortality. However not many studies have focused on this population.
Methods: Nonagenarians admitted to hospital with STEMI were identified in the National inpatient sample (NIS) database from 2010 to 2013 utilizing the SPSS. We determined the trend in utilization of PCI, in-hospital mortality, total costs for hospitalization and length of stay(LOS).
Results: Total of 4366 nonagenarians with STEMI were included in the study with 1130, 1167, 1068, 1001 in the years 2010, 2011, 2012 and 2013 respectively. Mortality without PCI remained high ranging from 27.44 % to 30.07% over the period of 4 years. The percentage of patients undergoing PCI steadily increased from 23.98% in 2010 to 32.57% in 2013. Overall in-hospital mortality for PCI group was 13.8% and No PCI group was 29.4%.(p <0.001). Mortality associated with PCI increased in the initial years from 10.7% in 2010 to 17.14% in 2012. However, in 2013 the mortality decreased to 12.58% which could be attributed to better patient selection. LOS for PCI group (4.99, SD 3.985) and no PCI group (4.94, SD 4.603, p = 0.733). Total hospitalization cost for PCI group (mean $ 86875, SD 56510) and no PCI group (mean $ 39761, SD 54368) with P < 0.001.
Conclusions: In nonagenarians mortality after STEMI is 29.4% without primary PCI. PCI reduces mortality risk to 13.8%. Age alone should not be a deciding factor in treating nonagenarians with PCI.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Updates in Stable Ischemic Heart Disease
Abstract Category: 3. Acute and Stable Ischemic Heart Disease: Therapy
Presentation Number: 1125-311
- 2017 American College of Cardiology Foundation