BACKGROUND: It remains unclear whether the superiority of primary percutaneous coronary intervention (PPCI) over thrombolysis for the treatment of ST elevation myocardial infarction (STEMI) extends to the very elderly. Furthermore, the deliverability and efficacy of PPCI in over the 80s has not been investigated in a real-world setting. The aim of this study was to compare outcome from STEMI in patients aged > or =80 before and after the introduction of routine 24/7 PPCI. METHODS: Retrospective observational analysis of all patients aged > or =80 presenting with STEMI to 2 neighboring hospitals in the 3-year period after the introduction of a 24/7 PPCI service and in the preceding 2 years when reperfusion therapy was by thrombolysis. RESULTS:Two hundred fifty-six STEMI patients aged > or =80 were included. After the introduction of PPCI, 84% (136/161) received reperfusion therapy, 73% PPCI, and 12% thrombolysis, compared to 77% ([73/95] 1% PPCI, 76% thrombolysis) previously. Mortality after inception of PPCI was reduced at 12 months (29% vs 41%, P = .04) and 3 years (43% vs 58%, P = .02). Improved outcome was attributable to treatment by PPCI, which was associated with numerically lower 12-month (26% vs 37%, P = .07) and significantly reduced 3-year (42% vs 55%, P = .05) mortality compared to thrombolysis. CONCLUSIONS: Primary PCI can be effectively delivered to very elderly patients presenting with ST elevation MI in a real-world setting and leads to a substantial reduction in mortality compared to patients treated by thrombolysis. Copyright 2010 Mosby, Inc. All rights reserved.
RCT Entities:
BACKGROUND: It remains unclear whether the superiority of primary percutaneous coronary intervention (PPCI) over thrombolysis for the treatment of ST elevation myocardial infarction (STEMI) extends to the very elderly. Furthermore, the deliverability and efficacy of PPCI in over the 80s has not been investigated in a real-world setting. The aim of this study was to compare outcome from STEMI in patients aged > or =80 before and after the introduction of routine 24/7 PPCI. METHODS: Retrospective observational analysis of all patients aged > or =80 presenting with STEMI to 2 neighboring hospitals in the 3-year period after the introduction of a 24/7 PPCI service and in the preceding 2 years when reperfusion therapy was by thrombolysis. RESULTS: Two hundred fifty-six STEMI patients aged > or =80 were included. After the introduction of PPCI, 84% (136/161) received reperfusion therapy, 73% PPCI, and 12% thrombolysis, compared to 77% ([73/95] 1% PPCI, 76% thrombolysis) previously. Mortality after inception of PPCI was reduced at 12 months (29% vs 41%, P = .04) and 3 years (43% vs 58%, P = .02). Improved outcome was attributable to treatment by PPCI, which was associated with numerically lower 12-month (26% vs 37%, P = .07) and significantly reduced 3-year (42% vs 55%, P = .05) mortality compared to thrombolysis. CONCLUSIONS: Primary PCI can be effectively delivered to very elderly patients presenting with ST elevation MI in a real-world setting and leads to a substantial reduction in mortality compared to patients treated by thrombolysis. Copyright 2010 Mosby, Inc. All rights reserved.
Authors: Els H Vandecasteele; Marc De Buyzere; Sofie Gevaert; Antoine de Meester; Carl Convens; Philippe Dubois; Jean Boland; Peter Sinnaeve; Herbert De Raedt; Pascal Vranckx; Patrick Coussement; Patrick Evrard; Christophe Beauloye; Marc Renard; Marc J Claeys Journal: Clin Res Cardiol Date: 2013-07-26 Impact factor: 5.460
Authors: Petr Kala; Jan Kanovsky; Richard Rokyta; Michal Smid; Jan Pospisil; Jiri Knot; Filip Rohac; Martin Poloczek; Tomas Ondrus; Maria Holicka; Jindrich Spinar; Jiri Jarkovsky; Ladislav Dusek Journal: BMC Cardiovasc Disord Date: 2012-04-25 Impact factor: 2.298
Authors: He Peiyuan; Yang Jingang; Xu Haiyan; Gao Xiaojin; Xian Ying; Wu Yuan; Li Wei; Wang Yang; Tang Xinran; Yan Ruohua; Jin Chen; Song Lei; Zhang Xuan; Fu Rui; Ye Yunqing; Dong Qiuting; Sun Hui; Yan Xinxin; Gao Runlin; Yang Yuejin Journal: PLoS One Date: 2016-11-03 Impact factor: 3.240