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42 Outcome of primary PCI in older population
  1. A Abdullah,
  2. M Ahmed,
  3. C Aherne,
  4. M Abdurahman,
  5. B Meany,
  6. T Kiernan
  1. University Hospital Limerick, Ireland

Abstract

Introduction STEMI is a leading cause of mortality. Several factors are associated with poor outcome. One of the major factors is increasing age. In this brief report we highlight the mortality and the characteristics of elderly patients (above 75 years of age) who presented with STEMI to our PCI centre.

Methods A retrospective review of clinical records of all patients who presented to PCI centre in University Hospital Limerick in the period from January to December 2014. Patients were allocated into two groups according to their age at time of presentation with group 1 representing patients who were 75 year-old or older, and group 2 included patients who were younger than 75 year-old.

Results Total of 223 patients were reviewed. 184 patients had confirmed diagnosis of STEMI. Primary PCI was performed in 182 patients and they were included in this analysis.

Group 1 (above 75-year old) included 49 patients (26.9%) while group 2 (<75 years old) included 133 patients. Females represnted 45 patients (24.7%). In hospital mortality in the first group was 18.4% (9 patients) while mortality in in the second group was 0% (P = 0.0001). The median length of stay (LOS) was 3 days in the first group vs 4 days in the second group (P = 0.45). Percentage of patients who presented with cardiac arrest on admission was 6.1% in first set of patients in comparison to 11.2% in the second group (P = 0.45). LAD obstructive pathology was identified as culprit lesion in 47.8% of the first group against 41.8% in the second set of patient (P = 0.56). Low EF (EF <40%) was 51% in first cohort of patients and 36.8% on the second group (P = 0.2). The use of IABP in the group 1 and group 2 was 16.3% and 13.2% respectively (P = 0.64).

Conclusion While the utilisation of primary PCI service by the elderly population in our centre has shown high proportion(26.9%), the mortality was extremely high. Important characteristics were included in this analysis; notably EF, use of IABP and cardiac arrest on admission to reflect clinical status on presentation. All theses parameters failed to show significant difference. For example the presence of cardiac arrest was noted to be higher in younger patients. This finding points to the fact that, the striking difference in mortality is probably due to other factors not analysed in this report. Increasing age is associated with increased medical co-morbidities. For complete understanding of the risks for mortality in this age group multivariate analysis with consideration of more variables is needed.

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