Comparison Of Outcomes For Acute Myocardial Infarction In Elderly People Over75Years: With And Without Percutaneous Coronary Intervention

Objectives: The aim of this study is to determine whether there aredifferences of in-hospital, and1-year follow-up clinical outcomes betweenacute myocardial infarction in elderly people over75years with andwithout percutaneous coronary intervention(PCI).Methods: Patients over75years old who admitted between April2011and December2012at our hospital with acute myocardial infarction areemployed, including both ST elevated myocardial infarction (STEMI) andNon-ST elevated myocardial infarction (NSTEMI),to evaluate the efficacyof PCI in prevention of adverse clinical events. Rates of major adversecardiovascular events (MACE),all-cause mortality, re-infarction,readmission rate due to congestive heart failure are reported and comparedbetween the group with PCI versus the group without PCI. Independentcorrelates of adverse outcomes were identified using multivariate binarylogistic regression analysis.Rsult: There is no statistical significance with clinical features besidesestimated glomerular filtration rate.Compared with the group with PCI,the group without PCI has more frequent recurrence of mortalityin-hospital(10.5%vs.25%),but without Statistical differences.However,thegroup without PCI was associated with a higher frequent recurrence ofall-cause mortality in one year follow-up(48.7%vs.18.4%,P<0.01) and dueto heart failure readmission rate(30.5%vs.11.8%,p<0.05).Correlationanalysis of the adverse clinic events related factors, found percutaneouscoronary intervention （P=0.01,95%CI0.02-0.53，OR:0.11）is a significantfactor of all-cause mortality in one-year follow-up;Conclusions: Our study indicated that PCI therapy reduced the rate ofmortality in patients older than75years during1year follow up,alsoreduce the rate of due to heart failure readmission rate,but can not reducemortality of in-hospital; PCI therapy is a predictor of better outcomes inpatients whom over75years with acute myocardial infraction.