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KMID : 0882420040670060580
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Korean Journal of Medicine
2004 Volume.67 No. 6 p.580 ~ p.588
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Clinical outcome in elderly patients older than 70 years with acute myocardial infarction after use of platelet glycoprotein IIb/IIIa receptor blocker during percutaneous coronary intervention : Comparison with those younger than 70 years
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Sim Doo-Sun
Jeong Myung-Ho
Lee Min-Goo
Hong Young-Joon
Park Hyung-Wook
Kim Weon
Kim Ju-Han
Ahn Young-Keun
Cho Jeong-Gwan
Park Jong-Chun
Ryu Sang-Wan
Ahn Byoung-Hee
Kim Sang-Hyung
Kang Jung-Chaee
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Abstract
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Background: This study was designed to evaluate the safety and clinical benefits of a glycoprotein IIb/IIIa receptor inhibitor, ReoPro® in the elderly patients with acute myocardial infarction (AMI) (?70 years of age) undergoing percutaneous coronary intervention (PCI).
Methods: AMI patients who underwent PCI with use of ReoPro® at Chonnam National University Hospital from Jan 2000 to Jan 2002 were divided into two groups: Group I (?70 years of age: 74±2.4 years, n=28) and Group II (<70 years of age: 56±8.0 years, n=122). Early and long-term clinical outcomes after PCI were analyzed in a retrospective fashion.
Results: As for risk factors and angiographic profiles, there were no differences between the two groups. Stenting was performed in 18 patients (64%) in group I and in 78 patients (63%) in group II. The incidence of gastrointestinal bleeding was 3 patients in group I and no patient in group II (p=0.005). At one-month evaluation, three cardiac deaths developed in group I, but no cardiac death in group II (p=0.005). During a period of 25±10.4 months of clinical follow-up, three cardiac deaths (11%) occurred in group I and 3 (2%) in group II, four AMIs (3%) in group II, and one stroke (0.8%) in group II. Target lesion revascularization (TLR) was performed in two patients (7%) in group I and in 24 patients (19%) in group II. No differences were found in the incidences of these variables between the two groups.
Conclusion: ReoPro® in elderly patients with AMI undergoing PCI entailed higher bleeding complications and early mortality. However, it has comparable clinical effect in elderly patients to younger patients during long-term clinical follow-up.(Korean J Med 67:580-588, 2004)
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KEYWORD
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Platelets, Receptor, Acute Myocardial Infarction, Angioplasty
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