Prognostic Impact of Primary Percutaneous Coronary Intervention in the Very Elderly STEMI Patient: Insights From the Codi Infart Registry.

The incidence of acute myocardial infarction (AMI) in elderly individuals is high. This population has higher rates of complications and represents a greater burden on health resources. Moreover, elderly individuals are underrepresented in clinical trials. A few randomized trials on reperfusion in elderly patients with AMI have included patients aged around 80 years, but extrapolation of these results to the general elderly population could be limited. Information on the impact of reperfusion on very elderly patients in everyday clinical practice is also limited. The objective of this study was to analyze the association between primary percutaneous coronary intervention and midterm mortality in very elderly patients with AMI and ST-elevation AMI (STEMI) attended in clinical practice after implementation of a regional program (June, 2009, Codi Infart). Two cohorts were studied. The first was a retrospective cohort of consecutive patients aged 80 years or more with STEMI who were not reperfused or who underwent fibrinolysis in tertiary hospitals (between 2005 and 2009). The second was a prospective cohort of consecutive patients aged 80 years or older with STEMI who underwent primary percutaneous intervention between 2010 and 2011, drawn from