Mir Ishraquzzaman
National Heart Foundation Hospital and research Institute,
Bangladesh
Abstract Title: Clinical Outcomes of Very Elderly (Aged >85 Years) STEMI Patients: Results from the NAMI Registry
Biography:
Dr. Mir Ishraquzzaman Consultant Cardiologist and Clinical Deputy Director. National Heart Foundation Hospital and research Institute
Research Interests:
Aims: Little is known regarding clinical outcome of very elderly patients with ST-segment elevation myocardial infarction (STEMI). The aim of this study was to compare clinical outcomes between very elderly patients (aged >85 years) and non-very-elderly patients (aged ≤85 years) with STEMI over a decade.
Methods and Results: The NAMI registry was conducted at a tertiary cardiac care hospital in Bangladesh from January 2015 to December 2024, spanning 10 years. All consecutive STEMI patients admitted to our hospital were included in the study. The clinical outcomes of very elderly and non-very-elderly patients were compared. A total of 14233 STEMI patients were included in this study, 135 (0.9%) patients were very elderly and 14098 (94.3%) were non-very-elderly. Many of very elderly patients were female (25.9% vs 13.8%; p<0.001). Very elderly patients had significantly more chronic kidney disease (97.0% vs 46.3%; p<0.001). Non-very-elderly patients were predominantly smokers (52.4% vs 34.1%; p<0.001); obese (35.1% vs 20.0%; p<0.001); and diabetic (53.4% vs 40.0%; p=0.002). Regarding CAG, vessel score did not differ significantly. Very-elderly patients received more medical therapy (67.4% vs 37.0%; p<0.001) and non-very-elderly patients received more thrombolytic therapy only (18.5% vs 8.1%; p=0.002) & underwent more pharmaco-invasive therapy (10.9% vs 5.9%; p=0.06), PCI (20.6% vs 9.6%; p=0.002), and primary PCI (13.1% vs 8.9%; p=0.15) than non-very-elderly patients. Very elderly patients had higher in-hospital complications: acute left ventricular failure (50.4% vs 29.6%; p<0.001); cardiogenic shock (23.0% vs 13.5%; p=0.002); conduction disturbance (18.5% vs 10.0%; p=0.001) arrhythmias (14.1% vs 8.2%; p=0.01) and in-hospital death (11.1% vs 4.1%; p<0.001) than non-very-elderly patients.
Conclusions: Very elderly patients had a higher prevalence of chronic kidney disease, were less likely to undergo invasive therapies, and had worse clinical outcomes.
