Clinical outcome in elderly patients older than 70 years with acute myocardial infarction after use of platelet glycoprotein IIb/IIIa receptor blocker during percutaneous coronary intervention : Comparison with those younger than 70 years / 대한내과학회지

ABSTRACT

BACKGROUND: This study was designed to evaluate the safety and clinical benefits of a glycoprotein IIb/IIIa receptor inhibitor, ReoPro(R) in the elderly patients with acute myocardial infarction (AMI) (>or=70 years of age) undergoing percutaneous coronary intervention (PCI). METHODS: AMI patients who underwent PCI with use of ReoPro(R) at Chonnam National University Hospital from Jan 2000 to Jan 2002 were divided into two groups Group I (>or=70 years of age 74 +/- 2.4 years, n=28) and Group II (<70 years of age 56 +/- 8.0 years, n=122). Early and long-term clinical outcomes after PCI were analyzed in a retrospective fashion. RESULTS: As for risk factors and angiographic profiles, there were no differences between the two groups. Stenting was performed in 18 patients (64%) in group I and in 78 patients (63%) in group II. The incidence of gastrointestinal bleeding was 3 patients in group I and no patient in group II (p=0.005). At one-month evaluation, three cardiac deaths developed in group I, but no cardiac death in group II (p=0.005). During a period of 25 +/- 10.4 months of clinical follow-up, three cardiac deaths (11%) occurred in group I and 3 (2%) in group II, four AMIs (3%) in group II, and one stroke (0.8%) in group II. Target lesion revascularization (TLR) was performed in two patients (7%) in group I and in 24 patients (19%) in group II. No differences were found in the incidences of these variables between the two groups. CONCLUSION: ReoPro(R) in elderly patients with AMI undergoing PCI entailed higher bleeding complications and early mortality. However, it has comparable clinical effect in elderly patients to younger patients during long-term clinical follow-up.