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Perl L, Franzé A, D’Ascenzo F, Golomb N, Levi A, Vaknin-Assa H, Greenberg G, Assali A, De Ferrari GM, Kornowski R. Elderly Suffering from ST-Segment Elevation Myocardial Infarction-Results from a Database Analysis from Two Mediterranean Medical Centers. J Clin Med 2021; 10:jcm10112435. [PMID: 34070865 PMCID: PMC8199382 DOI: 10.3390/jcm10112435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/12/2021] [Accepted: 05/27/2021] [Indexed: 01/06/2023] Open
Abstract
Background: Little is known regarding primary percutaneous coronary intervention (pPCI) for ST-segment elevation myocardial infarction (STEMI) in the elderly. Methods: Data on 319 octogenarians, 641 septuagenarians, and 2451 younger patients was collected from an ongoing prospective registry of patients treated with pPCI for STEMI at two Mediterranean-area medical centers in 2009–2017. Results: More octogenarian patients were female (40.8 vs. 31.9 septuagenarians and 26.5% under 70 y, p < 0.01), had hypertension (79.5 vs. 69.5 and 45.9%, p < 0.01), renal failure (32.5 vs. 20.1 and 5.2%, p < 0.01), and a lower left-ventricular ejection fraction (42.0 vs. 44.9 and 47.6%, p = 0.012). At 1 month and 3 years after intervention, mortality was higher in the octogenarian patients (12.2 vs. 7.9%, p = 0.01; and 36.7 vs. 23.1%, p < 0.01, respectively), with no significant differences in the rates of recurrent myocardial infarction, target vessel revascularization, coronary artery bypass surgery, and cardiovascular death. Following adjustment for confounders, 3-year mortality was significantly higher in the octogenarians (HR 3.89 vs. 3.19 for septuagenarians, p < 0.01), but rates of major adverse cardiac events or cardiovascular death were not. Conclusions: Despite suffering from higher all-cause mortality, octogenarian patients treated with pPCI for STEMI do not suffer an increased risk of ischemic cardiac events relative to younger patients.
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Affiliation(s)
- Leor Perl
- Department of Cardiology, Rabin Medical Center—Beilinson Hospital, Petach Tikva 4941492, Israel; (N.G.); (A.L.); (H.V.-A.); (G.G.); (R.K.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel;
- Correspondence: or ; Tel.: +972-3-9372251; Fax: +972-3-9372460
| | - Alfonso Franzé
- Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, University of Turin, Corso Bramante 88, 10126 Turin, Italy; (A.F.); (F.D.)
| | - Fabrizio D’Ascenzo
- Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, University of Turin, Corso Bramante 88, 10126 Turin, Italy; (A.F.); (F.D.)
| | - Noa Golomb
- Department of Cardiology, Rabin Medical Center—Beilinson Hospital, Petach Tikva 4941492, Israel; (N.G.); (A.L.); (H.V.-A.); (G.G.); (R.K.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel;
| | - Amos Levi
- Department of Cardiology, Rabin Medical Center—Beilinson Hospital, Petach Tikva 4941492, Israel; (N.G.); (A.L.); (H.V.-A.); (G.G.); (R.K.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel;
| | - Hana Vaknin-Assa
- Department of Cardiology, Rabin Medical Center—Beilinson Hospital, Petach Tikva 4941492, Israel; (N.G.); (A.L.); (H.V.-A.); (G.G.); (R.K.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel;
| | - Gabriel Greenberg
- Department of Cardiology, Rabin Medical Center—Beilinson Hospital, Petach Tikva 4941492, Israel; (N.G.); (A.L.); (H.V.-A.); (G.G.); (R.K.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel;
| | - Abid Assali
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel;
- Department of Cardiology, Meir Medical Center, Tchernichovsky St 59, Kfar-Saba 4428164, Israel
| | - Gaetano M. De Ferrari
- Department of Cardiology, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100 Pavia, Italy;
| | - Ran Kornowski
- Department of Cardiology, Rabin Medical Center—Beilinson Hospital, Petach Tikva 4941492, Israel; (N.G.); (A.L.); (H.V.-A.); (G.G.); (R.K.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel;
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