Abstract
Background: We sought to report the incidence of angiographic no-reflow and clinical outcomes of elderly patients who have undergone primary percutaneous coronary intervention at a tertiary institution in Singapore over a period of 10 years. Methods: A total of 141 patients (60% male) aged 75 or above underwent primary PCI between 1998 and 2007. Their average age was 80±5 years. Cardiogenic shock complicating STEMI on presentation accounted for 15% of the patients. Results: At baseline, 103 (73%) patients have impaired TIMI flow grade (TIMI 0–2), and 38 (27%) have normal flow (TIMI 3). At the end of the procedure, 44 (31.2%) patients had no-reflow phenomenon (TIMI 0–2), whereas 97 (68.8%) achieved normal antegrade flow. Post-procedure corrected TIMI frame count was analyzable in 66% (n=93) of the patients. Post-procedure corrected TIMI frame count was>28 in 37.6% (n=35) of patients. In-hospital, 30-day and six-month mortalities were 20.6, 25.5% and 27.7%, respectively. Multivariable analysis showed that age 80 or above, low systolic blood pressure and final TIMI 0–2 flow independently predicted six-month mortality. Conclusions: We found that one-third of the treated patients developed no-reflow phenomenon. Six-month mortality was 27.7%, most were cardiac deaths that occurred during index hospitalization.
Acknowledgement
The authors are indebted to the Publication Support Unit of the National University Hospital, Singapore for the assistance in preparation of the manuscript.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.