Primary Coronary Angioplasty vs Thrombolysis for the Management of Acute Myocardial Infarction in Elderly Patients

Abstract

In elderly patients who present with AMI, primary PTCA is associated with modestly lower short- and long-term mortality rates. In the subgroup of patients who were classified as ideal for reperfusion therapy, the observed benefit of primary PTCA was no longer significant.

Age Related Issues in Reperfusion of Myocardial Infarction

“…Several studies have shown that primary PCI (pPCI) in experienced centres is associated with improved outcomes compared with thrombolytic strategies in elderly patients with AMI [35,36]. However, most did not enrol adequate numbers of older patients, and only small trials have specifically addressed the question of fibrinolytic therapy vs PCI in older AMI patients (Table 1) [8,32,[37][38][39][40][41][42].…”

Clinical characteristics and early outcomes of very elderly patients in the reperfusion era

“…They also have a higher incidence of risk of bleeding than younger patients. Therefore, it was revealed that older patients with AMI are less likely to be treated with reperfusion strategy than younger patients [3,[11][12][13][14]. In 1996, Paul et al [12] reported that the use of thrombolysis was only 9% in 78 patients aged z75 years old whereas the use was 34% in 139 patients aged V65 years.…”

Accustomed to enduring: Experiences of African-American women seeking care for cardiac symptoms

“…7 However, the efficacy of therapy is directly related to the interval between symptom onset and treatment. 8 Patients who receive treatment within the first hour of the onset of symptoms receive the most benefit, but many patients do not receive reperfusion therapy because of excessive delay in seeking evaluation and treatment.…”