Infarctus du myocarde chez l'octogénaire traité par angioplastie primaire : pronostic hospitalier, devenir social et mortalité à long terme. Étude à propos d'une série de 47 patients

Abstract

This study evaluated the hospital outcome of octogenarian patients treated by primary angioplasty for acute myocardial infarction less than 12 hours. The long-term mortality and social outcome were evaluated, social outcome was based on IADL and IADL-E scales corresponding to physical autonomy and level of dependence. We included from 1999 to 2005 47 old patients of 83,5 ± 3,2 years. The reperfusion of the obstructed coronary artery was obtained in 45 patients (95,7%) with TIMI 3 flow. Hospital mortality was 25,5% and 4,2% without hemodynamic complication. A multivariate analysis identified a Killip score > 1 as predictive factor of hospital mortality (OR = 8,9 and p = 0,05). The long-term survival without death with a follow-up of 26,3 ± 18,3 months was 82,2% at 24 months and 70,6% at 48 months according to the Kaplan-Meier method. In an multivariate analysis, hospitalization exit without aspirine was associated with a higher long term mortality (OR = 34,8 and p = 0,04). According to the evolution of scores of IADL and IADL-E scales, patients had an excellent autonomy and good capacities before the infarction and they kept them on the long term. Thus octogenarians with acute myocardial infarction treated by primary angioplasty have a high in hospital and long term mortality but the survivors preserve an excellent daily autonomy.