Data supporting the use of the radial approach as the default strategy in octogenarians undergoing primary-PCI?

International Journal of Cardiology
Ashan GunarathneAnthony H Gershlick

Abstract

There is a significant increase in the number of octogenarians undergoing Primary Percutaneous Intervention (PPCI) for ST elevation myocardial infarction Objective: To analyze one year all cause mortality in octogenarians who are admitted with a STEMI and received PPCI in a tertiary cardiac centre in the UK, and to observe the impact of the mode of vascular access on mortality. We reviewed registry records of consecutive STEMI patients(N=2951), admitted between 2005 and 2011.Kaplan-Meier and Cox regression analyses were used to compare mortality between OG and Age group (50-79) years. Of the total population, 8.1% (n=241, Mean age: 85.3 yrs. (SD: 3.4)) were OG of whom 53.5% were male. Use of femoral arterial access (63%) was significantly higher among OG (P=0.04) compared to radial route. In univariate analysis, event free survival was significantly lower in OG (log rank test, P=0.001) compared to other age group. All cause mortality was significantly higher among patients who had femoral arterial access compared to radial route (log rank test, P=0.03) in OG. In Cox regression analysis conventional risk factors femoral access remained significantly associated with one year all cause mortality (Beta:-1.9(SE: 0.9, P=0.04). In our...Continue Reading

References

Apr 12, 2003·The American Journal of Medicine·Saif S RathoreHarlan M Krumholz
Apr 20, 2010·Archives of Gerontology and Geriatrics·Shmuel GottliebUNKNOWN Israeli Working Group on Intensive Cardiac Care, Israel Heart Society
Jun 19, 2010·The New England Journal of Medicine·Robert W YehAlan S Go

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Citations

Oct 6, 2016·Expert Review of Cardiovascular Therapy·Ashan GunarathneAnthony H Gershlick

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