Outcomes of primary percutaneous coronary intervention in older patients with heart attacks

This study examined people aged 85 years or older that were treated with primary percutaneous coronary intervention (PCI) after a heart attack. It was determined that PCI is relatively safe in these patients.

PCI is an urgent non-surgical procedure that is used to treat heart attacks. A heart attack, or myocardial infarction is due to the arteries supplying blood to the heart becoming narrowed or blocked. In PCI these arteries are widened or unblocked.

The risk of having a heart attack increases with age. However, people 85 years or older are underrepresented in studies of heart attacks or PCI.

The study examined 126 patients, 85 years old or older, who were treated with PCI after a heart attack. Compared to patients younger than 85, these patients were more likely to be female, to have high blood pressure, to have chronic kidney disease, or to have diabetes. They were less likely to be smokers.

24 patients (19%) died while in hospital after the procedure. Those who were older than 90, who had a severe heart attack, who waited a longer time to be treated, or who had a high risk of bleeding had a higher hospital mortality risk

The 102 participants who survived in hospital were examined for an average time of 898 days. At the end of follow-up, 69% of patients were alive. Seventeen patients had died from cardiac causes. The mortality risk was higher for those who had chronic kidney disease or a high risk of bleeding.

55 participants (53.9%) returned to hospital for at least one cardiovascular event during the study. Of these, 19 had either another heart attack or unstable angina (severe chest pain, even while resting). Thirty patients had at least one hospitalization for heart failure. Four patients had strokes and two had arrhythmias (abnormal heart rhythm). 

The study concluded that PCI is relatively safe in people 85 years or older. In these patients, PCI is associated with good survival (though not as good as younger patients), but a high rate of re-hospitalization due to cardiovascular causes.

This study only examined a small number of people. Thus the result may not apply equally to all people 85 years or older who experience a heart attack.