M-J de Boer1, J P Ottervanger2, A W J Van't Hof3,4, J C A Hoorntje3, H Suryapranata1, F Zijlstra5. 1. Radboud University Medical Centre, Nijmegen, The Netherlands. 2. Isala Hospital, Zwolle, The Netherlands. j.p.ottervanger@isala.nl. 3. Maastricht University Medical Centre, Maastricht, The Netherlands. 4. Zuyderland Medical Centre, Heerlen, The Netherlands. 5. Erasmus Medical Centre, Rotterdam, The Netherlands.
Abstract
BACKGROUND: Although the short-term benefit of primary percutaneous coronary intervention (PCI) in elderly patients with ST-elevation myocardial infarction (STEMI) has been demonstrated, the final long-term survival benefit is as yet unknown. AIM: To assess the final survival benefit of primary PCI as compared to thrombolytic therapy in patients over 75 years of age. METHODS: Patients > 75 years with STEMI were randomised to either primary PCI or thrombolysis. Long-term data on survival were available for all patients. RESULTS: A total of 46 patients were randomised to primary PCI, 41 to thrombolysis. There were no significant differences in baseline variables. After a maximum of 20 years' follow-up, all patients had passed away. The patients randomised to thrombolysis died after a mean follow-up duration of 5.2 years (SD 4.9) compared to 6.7 years (SD 4.8) in patients randomised to primary PCI (p = 0.15). Thus, the mean final survival benefit of primary PCI was 1.5 years. CONCLUSION: The final survival benefit of primary PCI as compared to thrombolysis in elderly patients with STEMI is 1.5 years and their life expectancy increases by 28.8%.
BACKGROUND: Although the short-term benefit of primary percutaneous coronary intervention (PCI) in elderly patients with ST-elevation myocardial infarction (STEMI) has been demonstrated, the final long-term survival benefit is as yet unknown. AIM: To assess the final survival benefit of primary PCI as compared to thrombolytic therapy in patients over 75 years of age. METHODS: Patients > 75 years with STEMI were randomised to either primary PCI or thrombolysis. Long-term data on survival were available for all patients. RESULTS: A total of 46 patients were randomised to primary PCI, 41 to thrombolysis. There were no significant differences in baseline variables. After a maximum of 20 years' follow-up, all patients had passed away. The patients randomised to thrombolysis died after a mean follow-up duration of 5.2 years (SD 4.9) compared to 6.7 years (SD 4.8) in patients randomised to primary PCI (p = 0.15). Thus, the mean final survival benefit of primary PCI was 1.5 years. CONCLUSION: The final survival benefit of primary PCI as compared to thrombolysis in elderly patients with STEMI is 1.5 years and their life expectancy increases by 28.8%.
Authors: Pin Pin Pek; Huili Zheng; Andrew Fu Wah Ho; Win Wah; Huay Cheem Tan; Ling Li Foo; Marcus Eng Hock Ong Journal: Emerg Med J Date: 2018-03-15 Impact factor: 2.740
Authors: Pernille G Thrane; Steen D Kristensen; Kevin K W Olesen; Leif S Mortensen; Hans Erik Bøtker; Leif Thuesen; Henrik S Hansen; Ulrik Abildgaard; Thomas Engstrøm; Henning R Andersen; Michael Maeng Journal: Eur Heart J Date: 2020-02-14 Impact factor: 29.983