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Title: Survival of elderly patients undergoing percutaneous coronary intervention for acute myocardial infarction complicated by cardiogenic shock.
Austin Authors: Lim, Han S ;Farouque, Omar ;Andrianopoulos, Nick;Yan, Bryan P;Lim, Chris C S;Brennan, Angela L;Reid, Christopher M;Freeman, Melanie;Charter, Kerrie;Black, Alexander;New, Gishel;Ajani, Andrew E;Duffy, Stephen J;Clark, David J 
Institutional Author: Melbourne Interventional Group
Affiliation: Department of Cardiology, Austin Hospital, Melbourne, Australia
Issue Date: 1-Feb-2009
Publication information: Jacc. Cardiovascular Interventions; 2(2): 146-52
Abstract: We sought to assess clinical outcomes of elderly patients (age >or=75 years) undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (MI) complicated by cardiogenic shock (CS) in a contemporary multicenter PCI registry.Although benefits of early PCI have been shown in younger groups, few studies have reported on clinical outcomes in elderly shock patients using current PCI techniques.We analyzed baseline characteristics and procedural and clinical outcomes in 143 consecutive patients presenting with MI and CS who underwent PCI from the Melbourne Interventional Group registry between 2004 and 2007.Of the 143 patients, 31.5% (n = 45) were elderly and 68.5% were younger (age <75 years). Elderly patients were more likely to be female (46.7% vs. 22.4%, p < 0.01) and have hypertension (77.8% vs. 46.4%, p < 0.01), previous MI (31.1% vs. 15.5%, p = 0.03), renal failure (24.4% vs. 11.3%, p < 0.05) and multivessel coronary artery disease (93.1% vs. 68.3%, p < 0.01). Stent (86.7% vs. 94.8%, p = 0.09), glycoprotein IIb/IIIa inhibitor (68.9% vs. 65.3%, p = 0.67), and intra-aortic balloon pump (57.8% vs. 58.2%, p = 0.97) use were similar in both groups. In-hospital, 30-day, and 1-year mortality in the elderly group versus the younger group were 42.2% vs. 33.7% (p = 0.32), 43.2% vs. 36.1% (p = 0.42), and 52.6% vs. 46.8% (p = 0.56), respectively.In this study, the 1-year survival of elderly patients with acute MI complicated by CS undergoing PCI was comparable to younger patients. These data suggest that in elderly patients presenting with CS, benefit is possible with selective use of early revascularization and merits further investigation.
Gov't Doc #: 19463417
DOI: 10.1016/j.jcin.2008.11.006
Journal: JACC. Cardiovascular interventions
Type: Journal Article
Subjects: Age Factors
Aged, 80 and over
Angioplasty, Balloon, Coronary.mortality
Confidence Intervals
Hospital Mortality
Kaplan-Meier Estimate
Logistic Models
Middle Aged
Multivariate Analysis
Myocardial Infarction.complications.drug therapy.etiology.mortality
Odds Ratio
Shock, Cardiogenic.etiology.mortality.therapy
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