BACKGROUND

1. Conservative Fibrinolysis PTCA p=0,049 *p=0,045 * p=0,532 * 0 1 2 Death (%) Relative risk PROGNOSIS IMPACT OF THE REVASCULARIZATION STRATEGY IN PATIENTS WITH AN ACUTE CORONARY SYNDROME WITH ST ELEVATION AGED  75 YEARS Filipe Seixo, José Ferreira Santos, on behalf of Investigators of the Portuguese Acute Coronary Syndromes Registry Cardiology Department - Hospital de São Bernardo – Setúbal - Portugal BACKGROUND Elderly patients presenting with an Acute Myocardial Infarction with ST-elevation (STEMI) have an increased risk of events compared to the rest of the population. The most aproppriate coronary revascularization strategy is still controversial. OBJECTIVES Determine the impact on short time prognosis of the different revascularization strategies - conservative, thrombolysis and primary angioplasty - on a population of old patients with STEMI. METHODOLOGY  1848 patients with STEMI aged ≥ 75 anos included on the Portuguese Acute Coronary Sundromes Registry (January 2002 - December 2005).  3 groups: Conservative Group (Group Cons) – no reperfusion Fibrinolysis Group – fibrinolysis PTCA group – primary angioplasty  Primary endpoint : intra-hospital death. RESULTS Reperfusion strategy *p value-1: p value for comparison Conservative Group vs. Fibrinolysis Group **p value-2: p value for comparison Conservative Group vs. PTCA Group ***p value-3: p value for comparison Fibrinolysis Group vs. PTCA Group Intra-hospitalar Death PTCA vs Conservative/Fibrinolysis Adjusted Hazard Ratio = 0,65 (CI 95% = 0,42-0,99) p=0,048 CONCLUSION Patients with STEMI aged ≥ 75 years are a very high risk group and the use of primary PTCA is associated with a decrease in the in-hospital mortality rate when compared with non-reperfusion and fibrinolysis.