Comparison of clinical outcomes between octogenarians and non-octogenarians with acute myocardial infarction in the drug-eluting stent era: Analysis of the korean acute myocardial infarction registry

Background and purpose: Octogenarians (age. ≥. 80 years) with coronary artery disease constitute a high-risk group. However, octogenarian patients with acute myocardial infarction (AMI) in the drug-eluting stents (DES) era have not been widely reported. We aimed to identify clinical outcomes in octogenarian compared with non-octogenarian AMI patients. Methods and subjects: We retrospectively analyzed 9877 patients who underwent percutaneous coronary intervention (PCI) with drug-eluting stents (DES) and who were enrolled in the Korean Acute Myocardial Infarction Registry (KAMIR). They were divided into 2 groups, octogenarians ( n=. 1494) and non-octogenarians ( n=. 8383), in order to compare the incidence of 1-year all-cause death and 1-year major adverse cardiac events (MACE), where MACE included all-cause death, recurrent myocardial infarction, target vessel revascularization (TVR), target lesion revascularization (TLR), and coronary artery bypass grafting (CABG). Results: The clinical status was significantly inferior in octogenarians compared to non-octogenarians: Killip class. ≥. II (34.8% vs. 22.5%, p<. 0.001), multivessel disease (65.8% vs. 53.7%, p<. 0.001). Rates of 1-year all-cause death were significantly higher in octogenarians than in non-octogenarians (22.3% vs. 6.5%, p<. 0.001). However, the rates of 1-year recurrent myocardial infarction (1.3% vs. 0.9%, p=. 0.68), TLR (2.4% vs. 3.1%, p=. 0.69), TVR (3.6% vs. 4.3%, p=. 0.96), and CABG (0.9% vs. 0.9%, p=. 0.76) did not differ significantly between the 2 groups. Conclusions: Octogenarian AMI patients have higher rates of mortality and MACE even in the DES era. According to KAMIR subgroup analysis, the TLR/TVR rates in octogenarians were comparable to those in non-octogenarian AMI patients.