J Korean Med Sci.  2014 Apr;29(4):527-535. 10.3346/jkms.2014.29.4.527.

Characteristics, In-Hospital and Long-Term Clinical Outcomes of Nonagenarian Compared with Octogenarian Acute Myocardial Infarction Patients

Affiliations
  • 1Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea. cecilyk@hanmail.net
  • 2Department of Internal Medicine, College of Medicine, Chungbuk National University, Chungju, Korea.
  • 3Department of Cardiovascular Medicine, East West Neo Medical Center, Seoul, Korea.
  • 4Department of Cardiovascular Medicine, Yeungnam University Hospital, Daegu, Korea.

Abstract

We compared clinical characteristics, management, and clinical outcomes of nonagenarian acute myocardial infarction (AMI) patients (n=270, 92.3+/-2.3 yr old) with octogenarian AMI patients (n=2,145, 83.5+/-2.7 yr old) enrolled in Korean AMI Registry (KAMIR). Nonagenarians were less likely to have hypertension, diabetes and less likely to be prescribed with beta-blockers, statins, and glycoprotein IIb/IIIa inhibitors compared with octogenarians. Although percutaneous coronary intervention (PCI) was preferred in octogenarians than nonagenarians, the success rate of PCI between the two groups was comparable. In-hospital mortality, the composite of in-hospital adverse outcomes and one year mortality were higher in nonagenarians than in octogenarians. However, the composite of the one year major adverse cardiac events (MACEs) was comparable between the two groups without differences in MI or re-PCI rate. PCI improved 1-yr mortality (adjusted hazard ratio [HR], 0.50; 95% confidence interval [CI], 0.36-0.69, P<0.001) and MACEs (adjusted HR, 0.47; 95% CI, 0.37-0.61, P<0.001) without significant complications both in nonagenarians and octogenarians. In conclusion, nonagenarians had similar 1-yr MACEs rates despite of higher in-hospital and 1-yr mortality compared with octogenarian AMI patients. PCI in nonagenarian AMI patients was associated to better 1-yr clinical outcomes.

Keyword

Aged, Eighty and over; Myocardial Infarction; Percutaneous Coronary Intervention

MeSH Terms

Acute Disease
Age Factors
Aged, 80 and over
*Angioplasty, Balloon, Coronary
Electrocardiography
Female
Hospital Mortality
Humans
Male
Myocardial Infarction/*diagnosis/mortality/therapy
*Percutaneous Coronary Intervention
Proportional Hazards Models
Registries
Treatment Outcome
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