Abstract

ARTUCIO, CAROLINA et al. Angioplastia coronaria en el infarto agudo de miocardio en pacientes con edad mayor o igual a 75 años. Rev.Urug.Cardiol. [online]. 2004, vol.19, n.1, pp.49-59. ISSN 1688-0420.

Aims: the objective of this study was to report the experience in the treatment of acute myocardial infarction (AMI) with primary angioplasty (PA) in our center, in 75-year-old patients (P) and older. Methods and results: from August /1995 to September/2001, 456 P with AMI were treated with PA,  81 P (17.8%) were ³ 75 years old. Mean age was 81,5 ± 5,2 years,  men were 38 P (46,9%), AMI location was anterior in  40 P (49,4%), Killip and Kimball (KK) class was III or IV in 22 P (27,2%). Mean time from pain onset to reperfusion was 180 minutes (P25-75:120-240). Stents were used in 82,7% of  P, with a rate of 0,9 stent / P. An angiographic successful result was obtained in 87,7%, and final TIMI flow grade III was achieved in 77,8%. In-hospital complications included: AMI in 1 P, surgical revascularization in 1 P (1,2% respectively), stroke in 2 P (2,4%), overall mortality rate was 17/81 (21,0%), and 7,7%, 5,0%, 60,0% and 52,9% in patients in KK class I, II, III, IV, respectively. Mortality of P without shock was 12,5%. Mortality in P ³ 75 years old with final TIMI flow grade 3 was  9/63 P (14,3%)  vs. 12/19 P (63,2%) in those with  TIMI flow <3, OR 4,42 (95% CI 2,21-8,86). Follow up was obtained in 75% of the P with  a survival rate of 50% at 20 months. Conclusions: timing of PA in this selected group of elder P was acceptable with high procedural success. Mortality in P with or without shock was congruent with those shown in other studies of elderly P with AMI

Keywords :  MYOCARDIAL INFARCTION; ANGIOPLASTY; AGED.