0443: Primary percutaneous coronary intervention for ST elevation myocardial infarction in nonagenarians: a multicentre study

Abstract

There are limited data on outcomes following primary percutaneous coronary intervention (PCI) for ST-segment elevation acute myocardial infarction (STEMI) in nonagenarian patients. We conducted a multicentre retrospective study between 2006 and 2013 in 5 international high-volume centers and included 145 nonagenarians treated with primary PCI for STEMI. Cardiogenic shock was present at admission in 21%. Mean delay between symptom onset and balloon was 5,8±7,6 hours and 60% of procedures were performed through the transradial approach. Successful revascularization of the culprit vessel was obtained in 86% of the cases (TIMI flow of 2 or 3). Major or clinically-relevant bleeding was observed in 4% of patients. Mean cardiac troponin Ic was 65±79 ng/ml and mean LVEF post-PCI was 42±13%. The in-hospital mortality was 24% with 6 months and 1 year survival of 58% and 49% respectively. In our study, primary PCI in nonagenarians with STEMI was successful and feasible through a transradial approach. It is associated with a high rate of successful reperfusion of the infarct-related artery and nearly 50% survival at one year. These results suggest that primary PCI should be offered in selected nonagenarians with acute myocardial infarction (table next page). Abstract 0443 – TableProcedural FindingsTime from symtoms to PCI (h)5.8±7.6Catheterizzation access (%)Radial60Single Vessel Coronary Disease (%)53Single Vessel Coronary PCI (%)74Infarct-related coronary artery (%)Left main4Left anterior descending41Circumflex14Right45CABG3Thrombus aspiration (%)14TMI flow grade after procedure (%)0121126381Coronary stenting (%)BMS75DES9POBA10Procedure success (%)Successful PCI86Failed PCI11Complicated PCI3Use of protection device (%)2IABP (%)0Use of inotropes during procedure (%)26 Abstract 0443 – Table