Temporal trends and in-hospital outcomes of primary percutaneous coronary intervention in nonagenarians with ST-segment elevation myocardial infarction

other Korea Acute Myocardial Infarction Registry Investigators

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background/Aims: Data regarding the outcomes of primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) in nonagenarians are very limited. The aim of the present study was to evaluate the temporal trends and in-hospital outcomes of primary PCI in nonagenarian STEMI patients. Methods: We retrospectively reviewed data from the Korea Acute Myocardial Infarction Registry (KAMIR) from November 2005 to January 2008, and from the Korea Working Group on Myocardial Infarction (KorMI) from February 2008 to May 2010. Results: During this period, the proportion of nonagenarians among STEMI patients more than doubled (0.59% in KAMIR vs. 1.35% in KorMI), and the rate of use of primary PCI also increased (from 62.5% in KAMIR to 81.0% in KorMI). We identified 84 eligible study patients for which the overall in-hospital mortality rate was 21.4% (25.0% in KAMIR vs. 20.3% in KorMI, p = 0.919). Multivariate analysis identified two independent predictors of in-hospital mortality, namely a final Thrombolysis in Myocardial Infarction (TIMI) flow <3 (odds ratio [OR], 13.7; 95% confidence interval [CI], 3.2 to 59.0; p <0.001) and cardiogenic shock during hospitalization (OR, 6.7; 95% CI, 1.5 to 30.3; p = 0.013). Conclusions: The number of nonagenarian STEMI patients who have undergone primary PCI has increased. Although a final TIMI flow <3 and cardiogenic shock are independent predictors of in-hospital mortality, primary PCI can be performed with a high success rate and an acceptable in-hospital mortality rate.

Original languageEnglish
Pages (from-to)821-828
Number of pages8
JournalKorean Journal of Internal Medicine
Volume30
Issue number6
DOIs
Publication statusPublished - 2015 Nov 1

Fingerprint

Percutaneous Coronary Intervention
Myocardial Infarction
Korea
Hospital Mortality
Registries
Cardiogenic Shock
Odds Ratio
ST Elevation Myocardial Infarction
Confidence Intervals
Mortality
Hospitalization
Multivariate Analysis

Keywords

  • Aged, 90 and over
  • In-hospital outcomes
  • Myocardial infarction
  • Percutaneous coronary intervention

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Temporal trends and in-hospital outcomes of primary percutaneous coronary intervention in nonagenarians with ST-segment elevation myocardial infarction. / other Korea Acute Myocardial Infarction Registry Investigators.

In: Korean Journal of Internal Medicine, Vol. 30, No. 6, 01.11.2015, p. 821-828.

Research output: Contribution to journalArticle

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title = "Temporal trends and in-hospital outcomes of primary percutaneous coronary intervention in nonagenarians with ST-segment elevation myocardial infarction",
abstract = "Background/Aims: Data regarding the outcomes of primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) in nonagenarians are very limited. The aim of the present study was to evaluate the temporal trends and in-hospital outcomes of primary PCI in nonagenarian STEMI patients. Methods: We retrospectively reviewed data from the Korea Acute Myocardial Infarction Registry (KAMIR) from November 2005 to January 2008, and from the Korea Working Group on Myocardial Infarction (KorMI) from February 2008 to May 2010. Results: During this period, the proportion of nonagenarians among STEMI patients more than doubled (0.59{\%} in KAMIR vs. 1.35{\%} in KorMI), and the rate of use of primary PCI also increased (from 62.5{\%} in KAMIR to 81.0{\%} in KorMI). We identified 84 eligible study patients for which the overall in-hospital mortality rate was 21.4{\%} (25.0{\%} in KAMIR vs. 20.3{\%} in KorMI, p = 0.919). Multivariate analysis identified two independent predictors of in-hospital mortality, namely a final Thrombolysis in Myocardial Infarction (TIMI) flow <3 (odds ratio [OR], 13.7; 95{\%} confidence interval [CI], 3.2 to 59.0; p <0.001) and cardiogenic shock during hospitalization (OR, 6.7; 95{\%} CI, 1.5 to 30.3; p = 0.013). Conclusions: The number of nonagenarian STEMI patients who have undergone primary PCI has increased. Although a final TIMI flow <3 and cardiogenic shock are independent predictors of in-hospital mortality, primary PCI can be performed with a high success rate and an acceptable in-hospital mortality rate.",
keywords = "Aged, 90 and over, In-hospital outcomes, Myocardial infarction, Percutaneous coronary intervention",
author = "{other Korea Acute Myocardial Infarction Registry Investigators} and Kim, {Joon Young} and Jeong, {Myung Ho} and Choi, {Yong Woo} and Ahn, {Yong Keun} and Chae, {Shung Chull} and Hur, {Seung Ho} and Hong, {Taek Jong} and Kim, {Young Jo} and Seong, {In Whan} and Chae, {In Ho} and Cho, {Myeong Chan} and Yoon, {Jung Han} and Seung, {Ki Bae} and Jeong, {Myung Ho} and Ahn, {Young Keun} and Chae, {Shung Chull} and Kim, {Jong Hyun} and Hur, {Seung Ho} and Kim, {Young Jo} and Seon, {In Whan} and Choi, {Dong Hoon} and Chae, {Jei Keon} and Hong, {Taek Jong} and Rhew, {Jae Young} and Kim, {Doo Il} and Chae, {In Ho} and Yoon, {Jung Han} and Koo, {Bon Kwon} and Kim, {Byung Ok} and Lee, {Myoung Yong} and Kim, {Kee Sik} and Hwang, {Jin Yong} and Cho, {Myeong Chan} and Oh, {Seok Kyu} and Lee, {Nae Hee} and Jeong, {Kyoung Tae} and Tahk, {Seung Jea} and Bae, {Jang Ho} and Rha, {Seung Woon} and Seung-Woon Rha and Kim, {Chong Jin} and Han, {Kyoo Rok} and Ahn, {Tae Hoon} and Kim, {Moo Hyun} and Seung, {Ki Bae} and Chung, {Wook Sung} and Yang, {Ju Young} and Rhim, {Chong Yun} and Gwon, {Hyeon Cheol} and Park, {Seong Wook}",
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T1 - Temporal trends and in-hospital outcomes of primary percutaneous coronary intervention in nonagenarians with ST-segment elevation myocardial infarction

AU - other Korea Acute Myocardial Infarction Registry Investigators

AU - Kim, Joon Young

AU - Jeong, Myung Ho

AU - Choi, Yong Woo

AU - Ahn, Yong Keun

AU - Chae, Shung Chull

AU - Hur, Seung Ho

AU - Hong, Taek Jong

AU - Kim, Young Jo

AU - Seong, In Whan

AU - Chae, In Ho

AU - Cho, Myeong Chan

AU - Yoon, Jung Han

AU - Seung, Ki Bae

AU - Jeong, Myung Ho

AU - Ahn, Young Keun

AU - Chae, Shung Chull

AU - Kim, Jong Hyun

AU - Hur, Seung Ho

AU - Kim, Young Jo

AU - Seon, In Whan

AU - Choi, Dong Hoon

AU - Chae, Jei Keon

AU - Hong, Taek Jong

AU - Rhew, Jae Young

AU - Kim, Doo Il

AU - Chae, In Ho

AU - Yoon, Jung Han

AU - Koo, Bon Kwon

AU - Kim, Byung Ok

AU - Lee, Myoung Yong

AU - Kim, Kee Sik

AU - Hwang, Jin Yong

AU - Cho, Myeong Chan

AU - Oh, Seok Kyu

AU - Lee, Nae Hee

AU - Jeong, Kyoung Tae

AU - Tahk, Seung Jea

AU - Bae, Jang Ho

AU - Rha, Seung Woon

AU - Rha, Seung-Woon

AU - Kim, Chong Jin

AU - Han, Kyoo Rok

AU - Ahn, Tae Hoon

AU - Kim, Moo Hyun

AU - Seung, Ki Bae

AU - Chung, Wook Sung

AU - Yang, Ju Young

AU - Rhim, Chong Yun

AU - Gwon, Hyeon Cheol

AU - Park, Seong Wook

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Background/Aims: Data regarding the outcomes of primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) in nonagenarians are very limited. The aim of the present study was to evaluate the temporal trends and in-hospital outcomes of primary PCI in nonagenarian STEMI patients. Methods: We retrospectively reviewed data from the Korea Acute Myocardial Infarction Registry (KAMIR) from November 2005 to January 2008, and from the Korea Working Group on Myocardial Infarction (KorMI) from February 2008 to May 2010. Results: During this period, the proportion of nonagenarians among STEMI patients more than doubled (0.59% in KAMIR vs. 1.35% in KorMI), and the rate of use of primary PCI also increased (from 62.5% in KAMIR to 81.0% in KorMI). We identified 84 eligible study patients for which the overall in-hospital mortality rate was 21.4% (25.0% in KAMIR vs. 20.3% in KorMI, p = 0.919). Multivariate analysis identified two independent predictors of in-hospital mortality, namely a final Thrombolysis in Myocardial Infarction (TIMI) flow <3 (odds ratio [OR], 13.7; 95% confidence interval [CI], 3.2 to 59.0; p <0.001) and cardiogenic shock during hospitalization (OR, 6.7; 95% CI, 1.5 to 30.3; p = 0.013). Conclusions: The number of nonagenarian STEMI patients who have undergone primary PCI has increased. Although a final TIMI flow <3 and cardiogenic shock are independent predictors of in-hospital mortality, primary PCI can be performed with a high success rate and an acceptable in-hospital mortality rate.

AB - Background/Aims: Data regarding the outcomes of primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) in nonagenarians are very limited. The aim of the present study was to evaluate the temporal trends and in-hospital outcomes of primary PCI in nonagenarian STEMI patients. Methods: We retrospectively reviewed data from the Korea Acute Myocardial Infarction Registry (KAMIR) from November 2005 to January 2008, and from the Korea Working Group on Myocardial Infarction (KorMI) from February 2008 to May 2010. Results: During this period, the proportion of nonagenarians among STEMI patients more than doubled (0.59% in KAMIR vs. 1.35% in KorMI), and the rate of use of primary PCI also increased (from 62.5% in KAMIR to 81.0% in KorMI). We identified 84 eligible study patients for which the overall in-hospital mortality rate was 21.4% (25.0% in KAMIR vs. 20.3% in KorMI, p = 0.919). Multivariate analysis identified two independent predictors of in-hospital mortality, namely a final Thrombolysis in Myocardial Infarction (TIMI) flow <3 (odds ratio [OR], 13.7; 95% confidence interval [CI], 3.2 to 59.0; p <0.001) and cardiogenic shock during hospitalization (OR, 6.7; 95% CI, 1.5 to 30.3; p = 0.013). Conclusions: The number of nonagenarian STEMI patients who have undergone primary PCI has increased. Although a final TIMI flow <3 and cardiogenic shock are independent predictors of in-hospital mortality, primary PCI can be performed with a high success rate and an acceptable in-hospital mortality rate.

KW - Aged, 90 and over

KW - In-hospital outcomes

KW - Myocardial infarction

KW - Percutaneous coronary intervention

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