We identified 545 patients < 65 years (354 with EA administration (> 30 min before PPCI), 191 late abciximab (LA)), and 541 patients ≥ 65 years of age (373 EA, 168 LA) in the EUROTRANSFER Registry database. Elderly patients were more likely to have comorbidities, angiographic PCI complications, and bleeding events. EA promotes infarct-related artery patency before PPCI and improves myocardial reperfusion after PPCI in both age groups, but the risk of 30-day death (EA vs. LA: < 65 years, 2.0 % vs. 1.6 % ; p = 0.999; ≥ 65 years, 5.9 % vs. 14.3 % ; p = 0.001) and 30-day death + reinfarction (EA vs. LA: < 65 years, 2.5 % vs. 2.1 % ; p = 0.999; ≥ 65 years, 7.5 % vs. 17.3 % ; p = 0.001) was reduced in elderly patients only. There was no difference in bleedings, especially major bleedings requiring transfusion (EA vs. LA: patients < 65 years, 2.3 % vs. 0 % , p = 0.055; ≥ 65 years, 2.4 % vs. 3 % ; p = 0.448) between groups.
Patients ≥ 65 years of age have a substantially increased risk of angiographic PCI complications, death and bleeding events compared with their younger counterparts. Strategy of EA before PPCI improves reperfusion parameters and clinical outcome in elderly patients and is not associated with elevated risk of major bleeding.