TY - JOUR
T1 - Long-term ischaemic and bleeding outcomes after primary percutaneous coronary intervention for ST-elevation myocardial infarction in the elderly
AU - Claessen, Bimmer E. P. M.
AU - Kikkert, Wouter J.
AU - Hoebers, Loes P.
AU - Bahadurzada, Hassina
AU - Vis, Marije M.
AU - Baan, Jan
AU - Koch, Karel T.
AU - de Winter, Robbert J.
AU - Tijssen, Jan G. P.
AU - Piek, Jan J.
AU - Henriques, José P. S.
PY - 2015
Y1 - 2015
N2 - Background The population is ageing rapidly and the proportion of patients aged >= 80 years undergoing primary percutaneous coronary intervention (PCI) is rising, but clinical trials have primarily been performed in younger patients. Methods Patients undergoing primary PCI between 2003 and 2008 were subdivided into 3 groups: <60, 60-79, and >= 80 years. Endpoints at 3-year follow-up included all-cause mortality, recurrent myocardial infarction (reMI), stent thrombosis, target lesion revascularisation (TLR), bleeding (BARC bleeding >= 3), stroke, and major adverse cardiovascular events (MACE, a composite of cardiac mortality, reMI, stroke and TLR). Results 2002 patients with ST-segment elevation myocardial infarction (STEMI) were included, 885 (44.2%) aged <60, 921 (46.0 %) 60-79, and 196 (9.7 %) >= 80 years. Comorbidities such as diabetes mellitus, prior stroke, malignant disease, anaemia, and chronic kidney disease were more prevalent in patients >= 80 years. The incidence of both ischaemic and bleeding events strongly increased with age. Age >= 80 years was an independent predictor of mortality (HR 2.56, 95 % CI1.69-3.87, p <0.001), a borderline nonsignificant predictor of overall bleeding (HR 1.38, 95 % CI 0.95-2.00, p = 0.088), and a significant predictor of non-access site bleeding (HR 2.26, 95 % CI 1.46-3.51, p <0.001). Conclusion Patients >= 80 years experienced high rates of ischaemic and bleeding complications; especially in this high-risk patient group individualised therapy is needed to optimise clinical outcomes
AB - Background The population is ageing rapidly and the proportion of patients aged >= 80 years undergoing primary percutaneous coronary intervention (PCI) is rising, but clinical trials have primarily been performed in younger patients. Methods Patients undergoing primary PCI between 2003 and 2008 were subdivided into 3 groups: <60, 60-79, and >= 80 years. Endpoints at 3-year follow-up included all-cause mortality, recurrent myocardial infarction (reMI), stent thrombosis, target lesion revascularisation (TLR), bleeding (BARC bleeding >= 3), stroke, and major adverse cardiovascular events (MACE, a composite of cardiac mortality, reMI, stroke and TLR). Results 2002 patients with ST-segment elevation myocardial infarction (STEMI) were included, 885 (44.2%) aged <60, 921 (46.0 %) 60-79, and 196 (9.7 %) >= 80 years. Comorbidities such as diabetes mellitus, prior stroke, malignant disease, anaemia, and chronic kidney disease were more prevalent in patients >= 80 years. The incidence of both ischaemic and bleeding events strongly increased with age. Age >= 80 years was an independent predictor of mortality (HR 2.56, 95 % CI1.69-3.87, p <0.001), a borderline nonsignificant predictor of overall bleeding (HR 1.38, 95 % CI 0.95-2.00, p = 0.088), and a significant predictor of non-access site bleeding (HR 2.26, 95 % CI 1.46-3.51, p <0.001). Conclusion Patients >= 80 years experienced high rates of ischaemic and bleeding complications; especially in this high-risk patient group individualised therapy is needed to optimise clinical outcomes
U2 - https://doi.org/10.1007/s12471-015-0733-2
DO - https://doi.org/10.1007/s12471-015-0733-2
M3 - Article
C2 - 26259967
SN - 1568-5888
VL - 23
SP - 477
EP - 482
JO - Netherlands heart journal
JF - Netherlands heart journal
IS - 10
ER -