Korean J Med.  2004 Dec;67(6):580-588.

Clinical outcome in elderly patients older than 70 years with acute myocardial infarction after use of platelet glycoprotein IIb/IIIa receptor blocker during percutaneous coronary intervention : Comparison with those younger than 70 years

• Sim DS
• Jeong MH
• Lee MG
• Hong YJ
• Park HW
• Kim W
• Kim JH
• Ahn YK
• Cho JG
• Park JC
• Ryu SW
• Ahn BH
• Kim SH
• Kang JC

Abstract

BACKGROUND: This study was designed to evaluate the safety and clinical benefits of a glycoprotein IIb/IIIa receptor inhibitor, ReoPro(R) in the elderly patients with acute myocardial infarction (AMI) (>or=70 years of age) undergoing percutaneous coronary intervention (PCI).
METHODS
AMI patients who underwent PCI with use of ReoPro(R) at Chonnam National University Hospital from Jan 2000 to Jan 2002 were divided into two groups: Group I (>or=70 years of age: 74 +/- 2.4 years, n=28) and Group II (<70 years of age: 56 +/- 8.0 years, n=122). Early and long-term clinical outcomes after PCI were analyzed in a retrospective fashion.
RESULTS
As for risk factors and angiographic profiles, there were no differences between the two groups. Stenting was performed in 18 patients (64%) in group I and in 78 patients (63%) in group II. The incidence of gastrointestinal bleeding was 3 patients in group I and no patient in group II (p=0.005). At one-month evaluation, three cardiac deaths developed in group I, but no cardiac death in group II (p=0.005). During a period of 25 +/- 10.4 months of clinical follow-up, three cardiac deaths (11%) occurred in group I and 3 (2%) in group II, four AMIs (3%) in group II, and one stroke (0.8%) in group II. Target lesion revascularization (TLR) was performed in two patients (7%) in group I and in 24 patients (19%) in group II. No differences were found in the incidences of these variables between the two groups.
CONCLUSION
ReoPro(R) in elderly patients with AMI undergoing PCI entailed higher bleeding complications and early mortality. However, it has comparable clinical effect in elderly patients to younger patients during long-term clinical follow-up.

Keyword

Platelets; Receptor; Acute Myocardial Infarction; Angioplasty

MeSH Terms

Aged*
Angioplasty
Blood Platelets*
Death
Follow-Up Studies
Glycoproteins*
Hemorrhage
Humans
Incidence
Jeollanam-do
Mortality
Myocardial Infarction*
Percutaneous Coronary Intervention*
Retrospective Studies
Risk Factors
Stents
Stroke
Glycoproteins