open access

Vol 66, No 7 (2008)
Other
Published online: 2008-07-23
Submitted: 2012-12-28
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Original article
Early percutaneous intervention improves survival in elderly patients with acute myocardial infarction complicated by cardiogenic shock

Liang Guo, Xiaoyan Mai, Jie Deng, Anheng Liu, Lun Bu, Haichang Wang
Kardiol Pol 2008;66(7):722-726.

open access

Vol 66, No 7 (2008)
Other
Published online: 2008-07-23
Submitted: 2012-12-28

Abstract


Background: The safety and effectiveness of emergency percutaneous coronary intervention (PCI) in elderly patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) are currently unknown.
Aim: To compare the outcome of elderly patients with AMI complicated by CS who were treated with primary PCI or thrombolysis.
Methods: Between 2001 and 2006 at Xijing Hospital we evaluated the outcome of 94 patients ł75 years old with AMI complicated by CS, of whom 33 underwent emergency PCI (PCI group), whereas the other 61 received initially conventional medication (CM group).
Results: Baseline characteristics, infarct location, rate of intra-aortic balloon pump support and time from AMI onset to therapy were similar between the two groups. The success rate of revascularisation in the PCI group was 90.9% and the success rate of thrombolysis in the CM group was 60.7% (p=0.004). The PCI group had a lower in-hospital mortality than the CM group (42.4 vs. 65.6%, p=0.026). Kaplan-Meier curves showed a significant difference in survival (48.48 vs. 21.31%, p=0.006), favouring early PCI. Multiple logistic regression identified time from AMI onset to therapy as an independent predictor of in-hospital death (p=0.036). Cox regression analysis indicated early PCI as an independent factor to improve mid-term survival (p=0.015).
Conclusions: Emergency PCI improves 1-year survival compared with initial conventional medication for elderly patients with AMI complicated by CS.

Abstract


Background: The safety and effectiveness of emergency percutaneous coronary intervention (PCI) in elderly patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) are currently unknown.
Aim: To compare the outcome of elderly patients with AMI complicated by CS who were treated with primary PCI or thrombolysis.
Methods: Between 2001 and 2006 at Xijing Hospital we evaluated the outcome of 94 patients ł75 years old with AMI complicated by CS, of whom 33 underwent emergency PCI (PCI group), whereas the other 61 received initially conventional medication (CM group).
Results: Baseline characteristics, infarct location, rate of intra-aortic balloon pump support and time from AMI onset to therapy were similar between the two groups. The success rate of revascularisation in the PCI group was 90.9% and the success rate of thrombolysis in the CM group was 60.7% (p=0.004). The PCI group had a lower in-hospital mortality than the CM group (42.4 vs. 65.6%, p=0.026). Kaplan-Meier curves showed a significant difference in survival (48.48 vs. 21.31%, p=0.006), favouring early PCI. Multiple logistic regression identified time from AMI onset to therapy as an independent predictor of in-hospital death (p=0.036). Cox regression analysis indicated early PCI as an independent factor to improve mid-term survival (p=0.015).
Conclusions: Emergency PCI improves 1-year survival compared with initial conventional medication for elderly patients with AMI complicated by CS.
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Keywords

myocardial infarction; shock; aging; revascularisation; survival

About this article
Title

Original article
Early percutaneous intervention improves survival in elderly patients with acute myocardial infarction complicated by cardiogenic shock

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 66, No 7 (2008)

Pages

722-726

Published online

2008-07-23

Bibliographic record

Kardiol Pol 2008;66(7):722-726.

Keywords

myocardial infarction
shock
aging
revascularisation
survival

Authors

Liang Guo
Xiaoyan Mai
Jie Deng
Anheng Liu
Lun Bu
Haichang Wang

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