P. Blanc et al., CORONARY ANGIOPLASTY IN ACUTE MYOCARDIAL- INFARCTION OF ELDERLY PATIENTS, Archives des maladies du coeur et des vaisseaux, 87(7), 1994, pp. 883-888
Myocardial infarction is a common and serious condition in patients ov
er 70 years of age. The aim of this study was to assess the feasabilit
y and efficacy of angioplasty without thrombolysis for revascularising
an occluded artery in this age group. Between March 1986 and December
1989, 32 patients over 70 years of age (average 76 +/- 3 years) under
went angioplasty without thrombolysis in the acute phase of myocardial
infarction. During the same period, 83 patients under 70 years of age
were treated in In the elderly subjects, the initial lesion was a tot
al occlusion in 26 out of 32 cases (81 %) and 99 % stenosis in the oth
er 6 cases (19 %), and was successfully revascularised in 28 of the 32
patients (87.5 %). Three episodes of ventricular fibrillation occurre
d during the procedure, one of which was lethal. A recurrence of pain
during the hospital period was observed in 3 patients, 1 of whom died
and the other 2 underwent repeat angioplasty. The hospital mortality w
as 5 patients (16 %), all of whom were over 75 years of age. The compa
rison with patients under 70 years of age showed a comparable primary
success rate, 87.5 % (28/32) versus 92 % (76/83) (p = 0.5), but a high
er mortality, 16 % (5/32) versus 4 % (4/83) (p < 0.05) and a tendency
to worse left ventricular function (ejection fraction 51 % versus 62 %
) and to more extensive coronary artery disease; on the other hand, th
e post-hospital outcome was the same in both groups; Globally, emergen
cy coronary angioplasty is a valuable alternative to thrombolysis for
the treatment of myocardial infarction in patients over 70 years of ag
e.