Open AccessCharacteristics, In-Hospital and Long-Term Clinical Outcomes of Nonagenarian Compared with Octogenarian Acute Myocardial Infarction Patients
Author(s) -
Ki Hong Lee,
Youngkeun Ahn,
Sung Soo Kim,
Si Hyun Rhew,
Young Wook Jeong,
Soo Young Jang,
Jae Yeong Cho,
Hae Chang Jeong,
Keun-Ho Park,
Nam Sik Yoon,
Doo Sun Sim,
Hwi Joong Yoon,
Kye Hun Kim,
Young Joon Hong,
Hyung Wook Park,
Ju Han Kim,
Jeong Gwan Cho,
Jong Chun Park,
Myung Ho Jeong,
Myeong Chan Cho,
Chong Jin Kim,
Young Jo Kim,
Kamir Investigators
Publication year - 2014
Publication title -
journal of korean medical science/journal of korean medical science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.743
H-Index - 66
eISSN - 1598-6357
pISSN - 1011-8934
DOI - 10.3346/jkms.2014.29.4.527
Subject(s) - medicine , conventional pci , myocardial infarction , percutaneous coronary intervention , hazard ratio , cardiology , confidence interval , adverse effect , diabetes mellitus , endocrinology
We compared clinical characteristics, management, and clinical outcomes of nonagenarian acute myocardial infarction (AMI) patients (n=270, 92.3 ± 2.3 yr old) with octogenarian AMI patients (n=2,145, 83.5 ± 2.7 yr old) enrolled in Korean AMI Registry (KAMIR). Nonagenarians were less likely to have hypertension, diabetes and less likely to be prescribed with beta-blockers, statins, and glycoprotein IIb/IIIa inhibitors compared with octogenarians. Although percutaneous coronary intervention (PCI) was preferred in octogenarians than nonagenarians, the success rate of PCI between the two groups was comparable. In-hospital mortality, the composite of in-hospital adverse outcomes and one year mortality were higher in nonagenarians than in octogenarians. However, the composite of the one year major adverse cardiac events (MACEs) was comparable between the two groups without differences in MI or re-PCI rate. PCI improved 1-yr mortality (adjusted hazard ratio [HR], 0.50; 95% confidence interval [CI], 0.36-0.69, P<0.001) and MACEs (adjusted HR, 0.47; 95% CI, 0.37-0.61, P<0.001) without significant complications both in nonagenarians and octogenarians. In conclusion, nonagenarians had similar 1-yr MACEs rates despite of higher in-hospital and 1-yr mortality compared with octogenarian AMI patients. PCI in nonagenarian AMI patients was associated to better 1-yr clinical outcomes.