ABSTRACT
To evaluate the prognosis of primary percutaneous coronary intervention [PPCI] and medical therapy [MT] in elderly patients presenting with ST-elevation myocardial infarction [STEMI]. A total of 238 STEMI patients aged above 80 and treated with PPCI [n = 186] and MT [n = 52] at Harefield Hospital, London were included in this study. Patients who did not have true STEMI based on non-diagnostic electrocardiogram [ECG] for STEMI and negative troponin, who presented with left bundle branch block [LBBB] and had normal coronaries were excluded from this study. Primary PCI was defined as any use of a guidewire for more than diagnostic purposes in patients with STEMI, whereas conventional MT was defined as treatment of patients with anti-platelets and anti-thrombotic medications without thrombolysis. The survival rate of PPCI patients was 86% [n = 160] at month 1 followed by 83.9% [n = 156] at month 6, and 81.2% [n = 151] at month 12. The survival rate of MT patients was 44.2% [n = 23] at month 1 followed by 36.5% [n = 19] at month 6, and 34.6% [n = 18] at month 12. Compared to MT, significantly fewer comorbidities were found in the PPCI group. Ventricular fibrillation [VF] [4.8%] and consequent admission to intensive care unit [7%] were the major complications of the PPCI group. PPCI has a higher survival rate and, compared to MT, fewer comorbidities were observed in the PPCI group of elderly patients presenting with STEMI