Abstract 11553: Percutaneous Coronary Intervention Outcomes in the Elderly: A Single Regional Centre Experience

Abstract

Background: Ischaemic heart disease is responsible for a significant health care burden in the elderly. The benefit from coronary revascularization with PCI in very elderly patients remains unclear. Purpose: We sought to assess the morbidity and mortality of very elderly patients (VEP; age ≥80 years) undergoing PCI, and compare outcomes to elderly patients (EP; 70-79 years). Methods: 820 consecutive patients (age ≥70 years) undergoing PCI over a three-year period were included (Jan 2012 to Jan 2015). Baseline characteristics, procedural details and clinical outcomes at three points of follow up (in-hospital, 30-day and 1-year) were recorded and patients were classified in to two groups, EP (n=508, 65% males) and VEP (n=312, 67% males). Results: 875 PCI procedures were evaluated, 553 (62%) in the EP group and 322 (38%) performed in VEP group. Baseline characteristics were similar in both groups. All comparative data are expressed as VEP vs. EP with p<0.05 unless otherwise stated. VEP were more likely than EP to undergo PCI for ACS [STEMI (35.3% vs. 22.0%), NSTEMI (47.9% vs. 44.7%)]. EP were more likely to have PCI for stable angina. VEP were more likely to receive three or more stents than EP (19.6% vs. 13.1%). Uni-variable relative risk analyses of mortality and post-procedural complications are shown in Figure 1. Global unadjusted in-hospital mortality was higher in the VEP group (9.1% vs. 4.9%). Global mortality was also higher in the VEP group at 30-day follow up (10.3% vs. 7.5%) and 1-year end point (18.6% vs. 8.7%). Among the post procedure complications, major bleeding requiring transfusion and renal failure were higher in the VEP, whilst stroke rates were not statistically different. Conclusions: Very elderly patients undergoing PCI have higher mortality and complication rate compared to elderly patients. The higher risk of complications may in part be explained by their higher likelihood to present with an ACS and more complex anatomy.