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KMID : 0191120140290040527
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Journal of Korean Medical Science
2014 Volume.29 No. 4 p.527 ~ p.535
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Characteristics, In-Hospital and Long-Term Clinical Outcomes of Nonagenarian Compared with Octogenarian Acute Myocardial Infarction Patients
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Lee Ki-Hong
Ahn Young-Keun
Kim Sung-Soo
Rhew Si-Hyun
Jeong Young-Wook
Jang Soo-Young
Cho Jae-Yeong
Jeong Hae-Chang
Park Keun-Ho
Yoon Nam-Sik
Sim Doo-Sun
Yoon Hyun-Joo
Kim Kye-Hun
Hong Young-Joon
Park Hyung-Wook
Kim Ju-Han
Cho Jeong-Gwan
Park Jong-Chun
Jeong Myung-Ho
Cho Myeong-Chan
Kim Chong-Jin
Kim Young-Jo
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Abstract
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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.
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KEYWORD
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Aged, Eighty and over, Myocardial Infarction, Percutaneous Coronary Intervention
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