• Ik Hyun Park, Hyun Kyu Cho, Ju Hyeon Oh, Woo Jung Chun, Yong Hwan Park, Young Bin Song, Joo-Yong Hahn, Seung-Hyuk Choi, Sang-Chol Lee, Hyeon-Cheol Gwon, Yeon Hyeon Choe, Jihoon Kim, and Woo Jin Jang.
• Division of Cardiology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.
• Am. J. Med. Sci. 2021 Dec 1; 362 (6): 592-600.

BackgroundLittle is known about the causality and pathological mechanism underlying the association between old age and myocardial injury in patients with ST-segment elevation myocardial infarction (STEMI). We evaluated the association between old age and myocardial injury in STEMI patients undergoing primary percutaneous coronary intervention (PCI) using cardiovascular magnetic resonance imaging (CMR).MethodsA total of 279 patients with STEMI who underwent primary PCI and CMR were enrolled. Of these, 52 patients were over the age of 70 years (18.6%, Age ≥70 group) and 227 patients were under the age of 70 years (81.4%, Age <70 group) at STEMI occurrence. We compared myocardial infarct size on CMR according to age at STEMI occurrence and performed inverse probability of treatment weighting.ResultsOn CMR analysis, myocardial infarct size on CMR tended to be greater in the Age ≥70 group than in the Age <70 group (21.2 ± 10.2% versus 19.5 ± 11.1%; p = 0.072). After performing inverse probability of treatment weighting adjustment, myocardial infarct size was significantly greater in the Age ≥70 group compared with the Age <70 group (22.6 ± 10.4% versus 19.6 ± 11.1%; p = 0.001). Subgroup analysis of patients older than 70 years revealed no significant difference in myocardial infarct size according to sex (20.1 ± 11.5% in females versus 20.4 ± 9.9% in males; p = 0.901).ConclusionsDespite appropriate coronary revascularization, old age was associated with greater extent of myocardial injury in STEMI patients.Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

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