Am J Cardiol：STEMI老年患者行PCI治疗功能恢复佳

　　美国一项研究表明，因ST段抬高型心肌梗死（STEMI）而行经皮冠脉介入（PCI）的80岁以上患者住院时间较短，功能恢复优异，并且有极有可能恢复至发病前生活状态。论文5月2日在线发表于《美国心脏病学杂志》（Am J Cardiol）。

　　尽管可产生死亡获益，但登记资料提示仍有高达55%的STEMI老年患者未接受再灌注治疗，并且接受直接PCI治疗老年患者的转归治疗相当匮乏。此项研究利用区域STEMI转送程序数据前瞻性分析了80岁以上STEMI患者的严重不良心脏事件、住院时间和出院状况。

　　结果显示，共有1323例序贯性STEMI患者被纳入研究，其中199例（15.0%）年龄≥80岁。在老年患者中，院内死亡率和1年死亡率分别为11.6%和25.6%。在166例年龄≥80岁、住院前独立或辅助生活并且生存的患者中，150例（90.4%）患者以相似生活状况出院或预计短期看护后将恢复至入院前状况。此类患者的中位住院时间为4天。

与心肌梗死相关的拓展阅读：

• 盘点：心肌梗死百年进展
• Circulation：西地那非不能降低心肌梗死后心脏舒张功能不全患者的心室充盈压
• Circulation:2013ST段抬高心肌梗死管理指南
• 失业增心肌梗死风险
• ACCA2012：女性比男性更易死于心肌梗死
• JID：流感易引发急性心肌梗死
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Comparison of Functional Recovery Following Percutaneous Coronary Intervention for ST Elevation Myocardial Infarction in Three Age Groups (<70, 70 to 79, and ≥80 Years).
Abstract
Functional outcomes of elderly patients ≥80 years who undergo percutaneous coronary intervention (PCI) for ST elevation myocardial infarction (STEMI) are unknown. Registry data indicate that up to 55% of elderly patients with STEMI do not receive reperfusion therapy despite a suggested mortality benefit, and only limited data are available regarding outcomes in elderly patients treated with primary PCI. Therefore, prospective data from a regional STEMI transfer program were analyzed to determine major adverse cardiac events, length of stay, and discharge status of consecutive patients with STEMI ≥80 years from March 2003 to November 2006. Of the 1,323 consecutive patients with STEMI treated in this regional STEMI system from March 2003 to November 2006, 199 (15.0%) were ≥80 years old. In-hospital mortality in elderly patients was 11.6%, with a 1-year mortality rate of 25.6%. Of the 166 patients with age ≥80 who lived independently or in assisted living before hospital admission and survived, 150 (90.4%) were discharged to a similar living situation or projected to such a living situation after temporary nursing home care. The median length of hospital stay was 4 days for these patients. In conclusion, elderly patients with age ≥80 receiving PCI for STEMI in a regional STEMI program have short hospital stays and excellent functional recovery on the basis of a very high rate of return to a similar previous living situation.