This article is more than 5 years old. Information may no longer be current.
APEX-AMI: Age strongest predictor of 90-day mortality
Gharacholou S. Arch Intern Med. 2011;171:559-567.
Click Here to Manage Email Alerts
Patients aged 75 years or older had nearly three times the rate of 90-day mortality after primary percutaneous coronary intervention compared with patients who were aged 65 to 74 years and more than five times the rate found in patients aged younger than 65 years. As a result, age was the strongest predictor of death at 90 days in this study’s population.
Among the patients (n=5,745) in the Assessment of Pexelizumab in Acute Myocardial Infarction (APEX-AMI) trial, 3,410 were aged younger than 65 years, 1,358 were aged 65 to 74 years, and 977 were aged 75 years or older. Ninety-day mortality and a composite of congestive HF, shock and 90-day death were defined as the study’s main outcome measures.
At baseline, patients aged 75 years or older had higher rates of hypertension, angina, stroke, chronic HF and chronic obstructive pulmonary disease. Overall, 90-day mortality rates were 2.3% in patients aged younger than 65 years, 4.8% in those aged 65 to 74 years and 13.1% in those aged 75 years or older. Composite outcomes shared a similar increase by age group (5.9%, 11.9% and 22.8%, respectively). After adjustment, age was the strongest independent predictor of 90-day mortality with an HR of 2.07 (95% CI, 1.84-2.33) per 10-year increase.
“Despite optimal mechanical reperfusion and high rates of adjunctive medical treatment, age remains the main predictor of 90-day mortality in STEMI patients treated with primary PCI,” the researchers wrote. “Efforts to attenuate this risk and understand reperfusion factors that increase age-associated outcomes are needed.”
 |
Follow CardiologyToday.com on Twitter. |