Cross-sectional Study of Percutaneous Intervention in the Elderly in Malaysia: PIELD Study

Abstract

Background: Worldwide, people are living longer. Most trials do not include elderly patients. Studies in the elderly are primarily subgroup analyses of major trials. Methods: This study investigated the outcomes of percutaneous coronary intervention (PCI) in the elderly (age ≥70 years). The primary outcomes were all-cause mortality and major adverse cardiovascular events (MACE) during the periprocedural period (up to 30 days) and 1 year after PCI. We also investigated the relationship between baseline characteristics and these cardiovascular outcomes. All elderly patients enrolled in the study underwent either urgent or elective PCI between 2007 and 2016. Data were obtained from electronic medical records. Patients (n=3,659) were divided into three groups: early-elderly (age 70–74 years, n=2,316), mid-elderly (age 75–79 years, n=1,037) and late-elderly (age ≥80 years, n=306). Results: All-cause mortality and MACE 30 days after PCI were significantly higher in the late-elderly group. One year after PCI, all-cause mortality remained highest in the late-elderly group, but MACE was highest in the mid-elderly group. Kaplan–Meier survival analysis showed that survival probability 1 year after PCI was highest in early-elderly (92.0%), followed by mid-elderly (88.9%), and lowest in late-elderly group (84.9%). Conclusion: Immediate outcomes (30 days) after PCI, in terms of both MACE and all-cause mortality, favour patients without chronic renal failure undergoing PCI in an elective setting. Mid-term outcomes (1 year) after PCI, in terms of all-cause mortality, favour patients without chronic heart failure or renal failure. In conclusion, revascularisation via PCI is safe, with acceptable short- (30 days) and mid-term (1 year) outcomes, in the elderly population.