Aim

The main purpose of the study is to assess the risk factors and angiographic profiles associated with different age group that impacts the likelihood of the outcome after primary percutaneous angioplasty in patients with ST–elevation myocardial infarction.

Method

This was a prospective, observational, single–centre study conducted at Pariyaram Medical College from the period between December 2011 and September 2012. The patients admitted for ST–elevation myocardial infarction and undergoing primary angioplasty were included in the study. Patients were divided into three groups based on their age, <40 years, 40–60 years and >60 years. Data were collected pertaining to risk factors, angiographic profile, ECG parameters and echo variables and recorded. Door to balloon time was also precisely measured and recorded. The primary end–point of the study is 30–day major adverse cardiac events rate. It is combination of death, reinfarction, repeat PCI, major bleeding and emergency CABG.

Results

There were 10 (5%) patients in the age group less than 40 years, 96 (48%) patients belonged to the age group between 40–60 years and 94 (47%) patients belonged to the age group greater than 60 years. Number of diabetics (43.6%) (p = 0.022) and hypertensives (44.7%) were more in the age group > 60 years of age as compared to other age groups. Smoking was significantly associated with age (p = 0.040) and higher number of patients was found in the age group below 60 years. Younger patients with family history of MI had more chances of MI at an early age (p = 0.001). Triple vessel disease was commonly observed in patients aged > 60 years (25.5%) as contrast to patients < 40 years (0%). The 30–day MACE was found to be 9.0%, which is a combination of 4.5 % death, 1.5 % re–infarction, 1.0 % major bleeds, 1.0% emergency CABG and 1.0% repeat PCI.

Conclusion

Age has a significant impact on outcomes after primary angioplasty owing to premorbid conditions at the time of presentation and diffused disease.