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Geriatr Gerontol Int · Apr 2017
Predictors of in-hospital mortality in octogenarian patients who underwent primary percutaneous coronary intervention after ST segment elevated myocardial infarction.
- Gokturk Ipek, Ozge Kurmus, Cemal Koseoglu, Tolga Onuk, Baris Gungor, Ozgur Kirbas, Mehmet B Karatas, Muhammed Keskin, Edibe Betul Borklu, Mert Ilker Hayiroglu, Ozan Tanik, Ahmet Oz, and Osman Bolca.
- Siyami Ersek Cardiothoracic Surgery Center, Department of Cardiology, Istanbul, Turkey.
- Geriatr Gerontol Int. 2017 Apr 1; 17 (4): 584-590.
AimOctogenarian patients have higher mortality and morbidity rates after acute coronary syndromes. Risk factors for in-hospital mortality in the primary percutaneous coronary intervention (PCI) era were underrepresented in previous studies. In the present study, we aimed to assess the risk factors of in-hospital mortality after primary PCI in this population.MethodsWe analyzed 2353 patients who underwent primary PCI after ST segment elevated myocardial infarction (STEMI). Patients were divided into two groups according to aged: ≥80 years (octogenarian) and <80 years (control). Risk factors for in-hospital mortality were analyzed in the whole group and octogenarian patients.ResultsWe found that octogenarians have 10.6-fold higher mortality risk after STEMI. After a univariate and multivariate analysis, acute stent thrombosis was the most explicit risk factor for in-hospital mortality in the octogenarian group (OR 21.13, 95% CI 2.11-102.76, P < 0.001). Additionally, anterior myocardial infarction (OR 4.90, 95% CI 1.90-22.10, P = 0.04), ventricular arrhythmias (OR 15.64, 95% CI 2.81-87.12, P = 0.002), multivessel disease (OR 6.5, 95% CI 1.11-38.85, P = 0.04), ejection fraction <30% (OR 1.24, 95% CI 0.26-6.00, P = 0.04) and KILLIP score ≥2 (OR 1.20, 95% CI 0.20- 7.41, P = 0.01) were also significantly associated with mortality.ConclusionsAcute stent thrombosis, anterior MI, heart failure, low ejection fraction, ventricular arrhythmias and multivessel disease are the independent risk factors for in-hospital mortality among octogenarian patients after primary PCI. Geriatr Gerontol Int 2017; 17: 584-590.© 2016 Japan Geriatrics Society.
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