Đánh giá kết quả can thiệp động mạch vành qua da thì đầu ở bệnh nhân cao tuổi bị nhồi máu cơ tim cấp có ST chênh lên

Abstract

Objective: To evaluate the outcomes of primary percutaneous coronary intervention (PCI) in patients aged ≥ 75 years with ST-elevation myocardial infarction (STEMI) within 30 days and 6 months post-intervention. Subject and method: This was a prospective observational study conducted on 104 patients aged ≥ 75 years diagnosed with STEMI and indicated for primary PCI at the Vietnam National Heart Institute - Bach Mai Hospital, Hanoi Heart Hospital, and Huu Nghi Hospital from 2018 to 2021. Result: The procedural success rate was high (99.0%), and clinical success was achieved in 93.3% of cases. TIMI 3 flow was restored in 99.0% of patients post-PCI. The average ST-segment elevation significantly decreased from 2.82 ± 1.39mm to 0.99 ± 1.08mm (p<0.001). During hospitalization, 89.4% of patients experienced no complications; both in-hospital mortality and stroke rates were 1.0%. At 30 days, the composite major adverse cardiac event (MACE) rate was 10.6%, including 6.7% mortality, 1.0% reinfarction, and 2.9% stroke. At 6 months, the MACE rate increased to 18.3%, including 11.5% mortality, 2.9% reinfarction, and 3.8% stroke. Echocardiography showed that the proportion of patients with EF ≥ 50% increased from 66.3% to 90.3%; regional wall motion abnormalities decreased from 80.8% to 40.2% (p<0.001). Conclusion: Primary PCI in elderly patients (≥ 75 years old) with STEMI demonstrates high procedural success and favorable short- and mid-term outcomes.