Primary Angioplasty in Patients Older Than 75 Years. Profile of Patients and Procedures, Outcomes, and Predictors of Prognosis in the ESTROFA IM + 75 Registry

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• 作者：José ; M. de la Torre Herná ; ndez^a ; ^{he1thj@humv.es} ; Salvatore Brugaletta^b ; Joan A. Gó ; mez Hospital^c ; José ; A. Baz^d ; Armando Pé ; rez de Prado^e ; Ramó ; n Ló ; pez Palop^f ; Belé ; n Cid^g ; Tamara Garcí ; a Camarero^a ; Alejandro Diego^h ; Federico Gimeno de Carlosⁱ ; José ; A. Ferná ; ndez Dí ; az^j ; Juan Sanchis^k ; Fernando Alfonso^l ; Roberto Blanco^m ; Javier Botasⁿ ; Javier Navarro Cuartero^o ; José ; Moreu^p ; Francisco Bosa^q ; José ; M. Vegas Valle^r ; Jaime Elí ; zaga^s ; Antonio L. Arrebola^t ; José ; R. Ruiz Arroyo^u ; Felipe Herná ; ndez-Herná ; ndez^v ; Neus Salvatella^w ; Marta Monteagudo^x ; Alfredo Gó ; mez Jaume^y ; Xavier Carrillo^z ; Roberto Martí ; n Reyes^aa ; Fernando Lozano^ab ; José ; R. Rumoroso^ac ; Leire Andraka^ad ; Antonio J. Domí ; nguez^ae
• 关键词：Elderly ; Myocardial infarction ; Primary angioplasty
• 刊名：Revista Española de Cardiología (English Edition)
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：70
• 期：2
• 页码：81-87
• 全文大小：258 K
• 卷排序：70

文摘

The proportion of elderly patients undergoing primary angioplasty is growing. The present study describes the clinical profile, procedural characteristics, outcomes, and predictors of outcome.MethodsA 31-center registry of consecutive patients older than 75 years treated with primary angioplasty. Clinical and procedural data were collected, and the patients underwent clinical follow-up.ResultsThe study included 3576 patients (39.3% women, 48.5% with renal failure, 11.5% in Killip III or IV, and 29.8% with > 6 hours of chest pain). Multivessel disease was present in 55.4% and nonculprit lesions were additionally treated in 24.8%. Radial access was used in 56.4%, bivalirudin in 11.8%, thromboaspiration in 55.9%, and drug-eluting stents in 26.6%. The 1-month and 2-year incidences of cardiovascular death were 10.1% and 14.7%, respectively. The 2-year rates of definite or probable thrombosis, repeat revascularization, and BARC bleeding > 2 were 3.1%, 2.3%, and 4.2%, respectively. Predictive factors were diabetes mellitus, renal failure, atrial fibrillation, delay to reperfusion > 6 hours, ejection fraction < 45%, Killip class III-IV, radial access, bivalirudin, drug-eluting stents, final TIMI flow of III, and incomplete revascularization at discharge.ConclusionsNotable registry findings include frequently delayed presentation and a high prevalence of adverse factors such as renal failure and multivessel disease. Positive procedure-related predictors include shorter delay, use of radial access, bivalirudin, drug-eluting stents, and complete revascularization before discharge.