Özet:

The treatment of elderly patients with ST segment elevated myocardial infarction (STEMI) remains controversial. This study aimed at investigating the effects of primary angioplasty in elderly patients on in-hospital and long-term major adverse cardiac events (MACE). Materials and methods: From October 2003 to March 2008, we retrospectively enrolled 220 patients aged 75 years and over with STEMI who underwent primary angioplasty. Patients\' characteristics, in-hospital and long-term events were recorded. Results: Male/Female ratio of patients was 129/91 and average age was 78.7 ± 3.6 (range, 75-97) years, and 58.6% of male). Of these patients 29.2% were diabetics, 69.8% were hypertensive, 34.4% were smokers and 43.5% were anemic at admission. Anterior myocardial infarction was diagnosed in 52.3% of patients. Mean pain-balloon time was 222 ± 116 minutes. Eighty two (38.2%) of these 220 patients had three-vessel disease and 12 (5.7%) were diagnosed as cardiogenic shock. Procedural success was observed in 79.6% of patients. Heart failure was observed 27.7% in hospital and intra aortic pump was used in 14.5% of patients. There was no significant difference between age groups in long-term major cardiac events and in hospital mortality. Diabetes, leukocyte count at admission and in hospital heart failure were independent predictors of short-term MACE and low hemoglobin level at admission and peak CKMB levels were independent predictors of long-term MACE. Conclusions: Primary angioplasty in patients aged 75 years and over seems to be associated with low proceural complication, high procedural success, improved short and long-term survival.

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