032 Differences in clinical presentation and 6-month outcomes in different age classes of elderly patients (75-80, 81-85, and >85 years). Data from prospective, nationwide, French PAPI registry

Abstract

Percutaneous coronary interventions (PCI) are proposed with increasing frequency to elderly and very elderly patients (pts) owing to the high prevalence of coronary disease in this age group. There are limited data about differences between aged and very aged pts in respect to risk factors, co morbidities and outcomes after PCI. We sought to define the differences in clinical presentation and outcomes in different age classes in elderly pts treated by PCI with stent implantation. 1955 pts aged >75 years (62% men, mean age 80.3±3.8 years) treated by 2072 PCI with 3352 stents implantations were prospectively included in this study. There were 936 pts (47.8%) aged 75-80 years, 707 pts (36.2%) between 81 and 85 years and 312 pts (16.0%) aged >85 years. Elderly and very elderly pts had less cardiovascular risk factors (hypercholesterolemia: 58% vs 54% vs 45%, p=0.01, diabetes: 36% vs 35% vs 32%, p=0.02, familial history of ischemic heart disease: 17% vs 12% vs 9.3%, p=0.002) but more often renal failure at admission (48% vs 65% vs 72% p<0.001). Unstable coronary syndromes as n indications for stenting increased with age (37% vs 44% vs 51%) p<0.001) as well as lesions concerning left main coronary disease or bypass grafts (p=0.04). 6-month cardiac mortality rate increased with age (1.6% vs 2.8% vs 5.2%, p=0.008) as well as cerebral vascular events (0.1% vs 0.8% vs 1.2%, p=0.03) while the rate of non fatal myocardial infarction remained similar (1.4% vs 2.0% vs 2.4%, p=NS). there are several difference in clinical presentation and 6-month outcomes in different age classes in elderly pts with ischemic heart disease treated by PCI with stent implantation with worse results in very elderly (>85%) pts.