Age and lack of β-blocker therapy are associated with increased long-term mortality after primary coronary angioplasty for acute myocardial infarction

Background: Few studies have examined the long-term outcome of primary PTCA for acute myocardial infarction, especially in thrombolysis-eligible patients. Methods: Retrospective analysis of a consecutive cohort of 228 patients treated with primary angioplasty for ST-segment elevation myocardial infarction, less than 6 h after symptom onset, of whom 203 were discharged alive and had long-term follow-up. Results: With an average follow-up of 497±40 days, actuarial survival rates were 94.4±0.02 and 86.8±0.06% at 2 and 4 years, respectively. Multivariate analysis showed that lack of β-blocker therapy at discharge (RR 6.5 and 95% CI: 1.97–21.47) and age (RR 1.09 per year and 95% CI: 1.03–1.16), but not left ventricular ejection fraction were the two independent predictors of late mortality. Conclusions: In thrombolysis-eligible patients treated with primary PCI and discharged alive, reinfarction and mortality rates are low. It appears particularly important to enforce prescription of β-blockers at discharge is an important goal in this population.