ROUTINE DELAYED PCI AFTER THROMBOLYTIC THERAPY IN ELDERLY PATIENTS WITH ACUTE ST ELEVATION MYOCARDIAL INFARCTION

The aim of this study was to investigate the efficacy and safety of percutaneous coronary intervention after thrombolytic reperfusion with indirect reperfusion signs in elderly patients with an acute ST elevation myocardial infarction. Materials and Methods. Patients aged ≥75 years with acute myocardial infarction and successful thrombolysis were included in this study. The criterion of exclusion was death in the first day of admission to hospital. A total of 96 patient charts were used for the analysis. In these patients, 31% of patients were selected for delayed PCI. In comparison, patients, not selected for PCI, were older, more often were women, more often had stroke in anamnesis, and less often presented with cardiogenic shock. Coronary angiography in patients with electrocardiographic signs of reperfusion demonstrated the presence of occlusion of infarct(related artery in 56.7% of cases. The stent implantation was performed in 70% of cases. The rates of recurrent myocardial infarction (ReMI) and lethality in patients aged ≥75 years with acute myocardial infarction (MI) as well as electrocardiographic signs of reperfusion after thrombolysis did not differ between groups of conservative therapy and delayed PCI: ReMI was 9.1% vs 6.7%; lethality rates were 13.6% and 10.0%, accordingly. The routine delayed PCI in elderly patient with acute myocardial infarction after successful thrombolysis is safe but its benefits still remains unclear.

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