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PCI Shows Benefit in Elderly With MI, Cardiogenic Shock

Older and younger heart attack patients showed similar survival after percutaneous intervention

FRIDAY, Feb. 20 (HealthDay News) -- Among patients with myocardial infarction and cardiogenic shock who underwent percutaneous coronary intervention, elderly patients showed similar one-year survival and other outcomes as younger patients, according to research published in the February Journal of the American College of Cardiology: Cardiovascular Interventions.

Han S. Lim, MBBS, of the Austin Hospital in Melbourne, Australia, and colleagues analyzed data from 143 patients with myocardial infarction (MI) and cardiogenic shock (CS), comparing outcomes in patients ages 75 and older with those of younger patients.

Though older patients were more likely to have renal failure, previous MI and hypertension, the in-hospital, 30-day and one-year mortality rates were similar for the elderly and younger groups (42.2 percent versus 33.7 percent, 43.2 percent versus 36.1 percent and 52.6 percent versus 46.8 percent, respectively).

"Why was the survival of elderly patients in our contemporary PCI (percutaneous coronary intervention) study more favorable than in previous reports? One possible explanation is the high rate of early reperfusion, with a median symptom-to-balloon time for elderly CS STEMI (ST-segment elevation myocardial infarction) patients of 228 min. Greater than 50 percent of patients (in both age groups) had a symptom-to-PCI time of less than six hours. Previous studies have shown that reperfusion time is especially important for survival in patients with CS compared with those without CS," the authors write.

The Melbourne Interventional Group, which conducted the study, receives funding from a number of pharmaceutical and medical device makers.

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