Trends in mortality rates in elderly ST elevation myocardial infarction patients submitted to primary percutaneous coronary intervention: A 7-year single-center experience

AIM: Limited data are available on the safety and outcome of percutaneous coronary intervention (PCI) in elderly patients with ST elevation myocardial infarction (STEMI), as elderly patients are under-represented in randomized trials. METHODS: We therefore aimed at assessing the trends in mortality rates (both at short-term and at 1-year follow up) in an unselected cohort of 404 STEMI patients aged ≥75 years all submitted to primary PCI and consecutively admitted to our Intensive Cardiac Care Unit from 2004 to 2010. RESULTS: In the first period (2004-2006), 202 patients (202/661, 30.6%) were aged ≥75 years, whereas in the second period (2007-2010), 203 patients (203/607, 33.4%) were aged ≥75 years. In the second period, STEMI patients were older (P < 0.001), more diabetic (P < 0.001) and with a higher incidence of comorbidities (P < 0.001). A significantly lower use of intra-aortic balloon pump was observed, together with a reduced rate of bleeding, whereas the incidence of worsening renal function significantly increased (P = 0.011). No difference was observed in the length of stay and in mortality rate (both in-hospital and 1-year post-discharge) between the first and the second period. CONCLUSIONS: According to our data, patients aged ≥75 years are characterized by an increasing number of comorbidities (in particular, a higher incidence of diabetes). Over a 6-year period, despite a more advanced age, early mortality (and length of stay) remained unchanged (probably thanks to a significant reduction in bleeding events), and no difference was observed in 1-year post-discharge mortality in these patients