Final benefit of primary percutaneous coronary intervention for ST-elevation myocardial infarction in older patients: long-term results of arandomised trial.

Abstract

Although the short-term benefit of primary percutaneous coronary intervention (PCI) in elderly patients with ST-elevation myocardial infarction (STEMI) has been demonstrated, the final long-term survival benefit is as yet unknown. To assess the final survival benefit of primary PCI as compared to thrombolytic therapy in patients over 75years of age. Patients > 75years with STEMI were randomised to either primary PCI or thrombolysis. Long-term data on survival were available for all patients. Atotal of 46patients were randomised to primary PCI, 41to thrombolysis. There were no significant differences in baseline variables. After amaximum of 20years' follow-up, all patients had passed away. The patients randomised to thrombolysis died after amean follow-up duration of 5.2years (SD 4.9) compared to 6.7years (SD 4.8) in patients randomised to primary PCI (p = 0.15). Thus, the mean final survival benefit of primary PCI was 1.5years. The final survival benefit of primary PCI as compared to thrombolysis in elderly patients with STEMI is 1.5years and their life expectancy increases by 28.8%.