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Age-related differences in antithrombotic therapy, success rate and in-hospital mortality in patients undergoing percutaneous coronary intervention

Results of the quality control registry of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte (ALKK)

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Abstract

Introduction

This analysis examines the influence of age on antithrombotic therapy, success rate of percutaneous coronary intervention (PCI) and in-hospital mortality in patients with Acute Coronary Syndrome (ACS) and elective PCI.

Methods

We analysed data of 26,795 unselected patients with ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), unstable Angina (UA) and elective PCI from the ALKK-PCI Registry 2006, a German prospective, multicentre registry.

Results

Elderly patients (>75) with ACS were significantly less often treated with acetylsalicylic acid intravenously and a clopidogrel loading dose of 600 mg. Moreover, the administration of GP IIb/IIIa antagonists was significantly lower in these patients. The rate of successful PCI (indicated as TIMI 3 flow) is comparable in younger and elderly patients with elective PCI, UA and NSTEMI, whereas there were more unsuccessful interventions in elderly patients with STEMI (13.2 vs. 11.0%, p < 0,033). In all indications elderly patients showed increased in-hospital mortality.

Conclusion

In clinical practice, elderly patients with ACS undergoing PCI receive significantly less intensive antithrombotic treatment. In terms of successful PCI, there was no significant difference between the age groups in patients with elective PCI, UA and NSTEMI. The higher in-hospital mortality of the elderly in all patient groups is most likely due to a higher rate of comorbidities.

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Conflict of interest

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Authors and Affiliations

  1. Herzzentrum Ludwigshafen, Medizinische Klinik B, Bremserstrasse 79, 67063, Ludwigshafen, Germany

    Arne Kristian Schwarz & Ralf Zahn

  2. Institut für Herzinfarktforschung Ludwigshafen, Bremserstrasse 79, 67063, Ludwigshafen, Germany

    Matthias Hochadel

  3. Klinik für Kardiologie, Herz- und Gefäß-Klinik, Bad Neustadt a. d. Saale, Germany

    Sebastian Kerber

  4. Abteilung für Kardiologie, Krankenhaus der Barmherzigen Brüder Trier, Germany

    Karl E. Hauptmann

  5. Medizinische Klinik II, Westpfalz-Klinikum, Kaiserslautern, Germany

    Hans-Georg Glunz

  6. Klinik für Kardiologie, Pneumologie und Internistische Intensivmedizin, Klinikum Neuperlach, Städtisches Klinikum München, München, Germany

    Harald Mudra

  7. Kardiologie, Angiologie und konservative Intensivmedizin, Vivantes Klinikum Neukölln, Berlin, Germany

    Harald Darius

  8. Herzzentrum Ludwigshafen, Medizinische Klinik B, Institut für Herzinfarktforschung Ludwigshafen, Bremserstrasse 79, 67063, Ludwigshafen, Germany

    Uwe Zeymer

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  1. Arne Kristian Schwarz
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  2. Ralf Zahn
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  4. Sebastian Kerber
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  9. Uwe Zeymer
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Correspondence to Uwe Zeymer.

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Schwarz, A.K., Zahn, R., Hochadel, M. et al. Age-related differences in antithrombotic therapy, success rate and in-hospital mortality in patients undergoing percutaneous coronary intervention. Clin Res Cardiol 100, 773–780 (2011). https://doi.org/10.1007/s00392-011-0311-6

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  • DOI: https://doi.org/10.1007/s00392-011-0311-6

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