028 Age related mortality of primary PCI patients at a high volume UK cardiac centre

Introduction Despite being the fastest growing population group, the elderly have usually been excluded from reperfusion clinical trials. We studied the difference in mortality in different age groups after primary percutaneous coronary intervention (PPCI) for ST elevation myocardial infarction (STEMI) at our high volume 24/7 cardiac centre. Methods From the start of our PPCI service, there has been no age criteria to access the service. We collected data from our prospective cardiac database for the 24-months period between September 2009 and September 2011, with mortality provided by the summary care records. Results There were 1322 PPCI procedures with an age range of 14–98 years (mean 65.3). 656 patients (50%) were under 65 years, 326 (25%) were 65–74, 243 (18%) were 75–84 and 97 (7%) were 85 years or over. The 30-day all-cause mortality rates are shown in the graph below. Conclusions The data presented demonstrate a clear significant correlation between age and mortality following PPCI. For those patients aged under 65 years, the 30-day mortality following PPCI for STEMI is very low. There is then a stepwise increase in mortality with age. This report from a high volume centre adds to the sparse literature documenting outcome for the elderly following PPCI in an unselected “all-comer” real world population. It raises the issue of what the most appropriate treatment strategy should be in very elderly patients presenting with STEMI and warrants further investigation.