Primary percutaneous coronary intervention in patients aged 85 years or older: a retrospective analysis of outcomes.

Abstract

Primary percutaneous coronary intervention (PPCI) is the first-line treatment for acute ST-elevation myocardial infarction (STEMI). Evidence of benefit from PPCI in the elderly is sparse. Our aim was to evaluate survival outcomes in patients aged ≥85 years who undergo PPCI for STEMI. Clinical data were collected retrospectively on all patients aged ≥85 years who were referred and accepted for PPCI to our centre between 2013 and 2018. One hundred and forty-three patients received PPCI. Median hospital stay was seven days. One hundred and thirty-one patients survived admission. One-year mortality was 33.5%. Age and baseline renal function were independent predictors of one-year mortality. Median survival was 2.55 years. Advanced age alone should not be used as an exclusion criterion for PPCI; rather, a personalised approach that takes into account all clinically relevant patient factors should guide PCI decision-making. Our findings suggest that PPCI as first-line treatment for STEMI in the very old should be considered routinely.