Comparison of clinical outcomes between octogenarians and non-octogenarians with acute myocardial infarction in the drug-eluting stent era: Analysis of the Korean Acute Myocardial Infarction Registry

Title
Comparison of clinical outcomes between octogenarians and non-octogenarians with acute myocardial infarction in the drug-eluting stent era: Analysis of the Korean Acute Myocardial Infarction Registry
Author(s)
김영조Futoshi Yamanaka[Futoshi Yamanaka]정명호[정명호]shigeru saito[shigeru saito]채성철[채성철]허성호[허성호]홍택정[홍택정]성인환[성인환]배장호[배장호]조정환[조정환]
Keywords
ACUTE CORONARY SYNDROMES; ELDERLY-PATIENTS; BARE-METAL; PRIMARY ANGIOPLASTY; EUROPEAN-SOCIETY; SIROLIMUS; MORTALITY; ARTERIES; TRIALS; REVASCULARIZATION
Issue Date
201310
Publisher
ELSEVIER IRELAND LTD
Citation
JOURNAL OF CARDIOLOGY, v.62, no.3-4, pp.210 - 216
Abstract
Background and purpose: Octogenarians (age >= 80 years) with coronary artery disease constitute a high-risk group. However, octogenarian patients with acute myocardial infarction (AMI) in the drug-eluting stents (DES) era have not been widely reported. We aimed to identify clinical outcomes in octogenarian compared with non-octogenarian AMI patients. Methods and subjects: We retrospectively analyzed 9877 patients who underwent percutaneous coronary intervention (PCI) with drug-eluting stents (DES) and who were enrolled in the Korean Acute Myocardial Infarction Registry (KAMIR). They were divided into 2 groups, octogenarians (n=1494) and non-octogenarians (n=8383), in order to compare the incidence of 1-year all-cause death and 1-year major adverse cardiac events (MACE), where MACE included all-cause death, recurrent myocardial infarction, target vessel revascularization (TVR), target lesion revascularization (TLR), and coronary artery bypass grafting (CABG). Results: The clinical status was significantly inferior in octogenarians compared to non-octogenarians: Killip class >= II (34.8% vs. 22.5%, p<0.001), multivessel disease (65.8% vs. 53.7%, p<0.001). Rates of 1-year all-cause death were significantly higher in octogenarians than in non-octogenarians (22.3% vs. 6.5%, p<0.001). However, the rates of 1-year recurrent myocardial infarction (1.3% vs. 0.9%, p = 0.68), TLR (2.4% vs. 3.1%, p = 0.69), TVR (3.6% vs. 4.3%,p = 0.96), and CABG (0.9% vs. 0.9%, p=0.76) did not differ significantly between the 2 groups. Conclusions: Octogenarian AMI patients have higher rates of mortality and MACE even in the DES era. According to KAMIR subgroup analysis, the TLR/TVR rates in octogenarians were comparable to those in non-octogenarian AMI patients. (C) 2013 Published by Elsevier Ltd on behalf of Japanese College of Cardiology.
URI
http://hdl.handle.net/YU.REPOSITORY/28839http://dx.doi.org/10.1016/j.jjcc.2013.04.003
ISSN
0914-5087
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의과대학 > 내과학교실 > Articles
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