Myocardial reperfusion efficacy in elderly patients with ST elevation myocardial infarction

The aim of this study was to compare the reperfusion methods in patients with STEMI between two age groups: >70 years (n=197) and <70 years (n=253). The patients in these groups were admitted to the hospital within the same time after the onset of myocardial infarction: 2.5 hours. As the primary reperfusion method, thrombolytic therapy was used more often in patients of older group: 55% versus 48%. Primary PCI was used accordingly less frequently: 45% versus 52% (ns). Prehospital thrombolysis was conducted less frequently at the prehospital stage in older patients compared with the younger group: 36% versus 65% (р<0.05). The rates of coronary artery reperfusion 90 min after thrombolysis did not significantly differ between two groups: 51% and 55%. The older patients underwent coronary angiography after thrombolysis and PCI less frequently compared with younger patients: 39% versus 61% (ns) and 18% versus 46% (p<0.05) for coronary angiography and PCI, respectively. The older patients had higher rates of bleeding complications (22% versus 10%; р<0.05) and inhospital mortality (17.3% versus 4.3%; р<0.05). We currently do not have clear guidelines or algorithms for indications for PCI in elderly patients who have high risk of bleeding complications. This question remains unsolved requiring further studies.

инфаркт миокарда, реперфузия миокарда, тромболизис, стентирование коронарных артерий, старческий возраст, myocardial infarction, reperfusion, thrombolysis, PCI, pharmacoinvasive strategy, elderly

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