Enter Your Email Address to Receive a
Copy of MedicExhange Member Demograhpics

Elderly patients with acute STEMI benefit as much as younger patients from primary angioplasty as opposed to fibrinolysis, according to a report.

Elderly patients with acute ST-elevation myocardial infarction (STEMI) benefit as much as younger patients from primary angioplasty as opposed to fibrinolysis, according to a report in the August issue of the American Heart Journal.

"Primary percutaneous intervention (pPCI) is a safe treatment in the elderly, and the effect of pPCI is at least as great for these patients as for younger ones," Dr. Emil Loldrup Fosbol from University Hospital of Copenhagen, Denmark, told Reuters Health.

Dr. Fosbol and colleagues used data from the Danish Multicenter Randomized Study on Fibrinolytic Therapy Versus Acute Coronary Angioplasty in Acute Myocardial Infarction (DANAMI-2) substudy to assess the effect of primary angioplasty versus fibrinolysis across age groups.

The long-term superiority of angioplasty over fibrinolysis on the combined end point of mortality, recurrent myocardial infarction, and stroke was independent of age, the authors report.

For mortality specifically, there was no significant effect of angioplasty versus fibrinolysis in any age group, the researchers note.

Results were similar regardless of whether ages were divided into decades, stratified into quartiles, or divided into two groups according to age over or under 80 years.

"If patients can be transported to an invasive center to receive pPCI, this should always be the goal for the clinician - no matter what age," Dr. Fosbol concluded.

"Future trials could help address whether combination therapy of fibrinolysis during transportation to an invasive center, where pPCI then could be performed, could be even more efficient at decreasing reinfarctions, strokes, and death," Dr. Fosbol added. "A new trial focusing on elderly patients who are not suited for fibrinolysis due to contraindications is relevant, because these possibly could benefit greatly from an invasive strategy."

Am Heart J 2008;156:391-396