Primary percutaneous interventions for acute myocardial infarction in octogenarians: A single-center experience

Background: The majority of cardiovascular deaths occur in the elderly. The safety and results of primary infarct intervention in octogenarians is not well characterized. Hypothesis: The purpose of this study was to compare the results of primary infarct intervention in octogenarians with those in younger patients during 1997-1998 and to compare these results to those obtained in octogenarians treated in 1991-1994. Methods: During 1997-1998, 40 octogenarians were treated with primary infarct intervention and were compared with 60 randomly selected patients aged < 80 years treated during the same time period. The results in octogenarians were compared with the results in a group of 37 patients of similar age treated in 1991-1994. The baseline characteristics, procedural results, and hospital outcome were obtained from a prospectively designed interventional database at a busy single-center program. Results: There was no significant difference in hospital survival between the two groups of patients treated in 1997-1998 although there was a trend toward higher mortality in the octogenarian group. Length of stay and use of intro-aortic balloon pumps were greater in the octogenarian group. When the results in octogenarians treated in 1997-1998 were compared with the group of 37 patients treated in 1991-1994, the hospital mortality declined from 27 to 10% (p = 0.05). Conclusions: There has been improvement in hospital mortality over the past decade for patients aged greater than or equal to 80 years treated with primary infarct intervention. Hospital resources and length of stay are greater for the octogenarian group. Ongoing research studies are comparing the results of thrombolytic therapy and primary intervention in aged patients.