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Age was reported as a significant risk factor for coronary artery disease. The World widely, the age of 65 years was accepted as a definition of 'elderly' or older person. However, there was no guideline for the very elderly patients (≥80 years) with ST-segment elevated myocardial infarction (STEMI) treated with PCI. Therefore, we investigated the impact of very old age (≥80 years) on long-term prognosis in elderly patients who were treated with PCI for STEMI.
A total of 337 elderly patients who were treated with PCI due to STEMI were analyzed. Patients were divided into the two groups according to the age: 65-79 years patients (n=269) vs over 80 years patients (n=68).
Baseline clinical characteristics showed that past history of PCI (14.9% vs 4.4%, p=0.024), diabetes mellitus (39.0%, vs 13.2%, p<0.001), and smoking (38.7% vs 20.6%, p=0.007) were higher in elderly patients as compared with very elderly patients. Angiographic characteristics were similar between the two groups. Clinical outcomes showed that mortality up to 30 days were higher in very elderly patients, but total mortality up to 3 years were similar between the two groups. (Table 1) Multivariate regression showed that very old age (≥80 years, HR 3.5, CI 1.16-10.7, p=0.026), past history of cerebrovascular events (HR 4.7, CI 1.4-15.4, p=0.011), and past history of coronary bypass graft (HR 1.8, CI 1.0-3.2, p=0.044) were independent risk factors for mortality up to 3 years.
Very old age was associated with short-term mortality and was an independent risk factor for mortality up to 3 years. Therefore, more intensive and careful therapies will be needed for very elderly patients with STEMI treated with PCI.