Abstract
Objectives. To observe the short- and long-term outcomes after percutaneous coronary intervention (PCI) in octogenarians (>80 y.o.) at our institution. Method. All octogenarians who underwent PCI during the study period were retrospectively retrieved from our database and clinically followed. Major adverse cardiac (and cerebral) events (MAC(C)E) was considered as primary outcome. Results. From January 2003 to December 2007, 140 octogenarians (mean age: 85±3 y.o., 79% of male) underwent PCI and were clinically followed 14±11 months. Procedural success was obtained in 100 percent of patients with single vessel disease, in 96 percent of patients with double vessel disease, and in 75 percent of patients with triple vessel disease. In-hospital, 30 days, and one year MACE rates were 5%, 5%, and 10.7%, respectively. Impaired left ventricular (LV) ejection fraction (hazard ratio (HR) = 0.909, 95% confidence interval (CI) = 0.856 to 0.964, P = .002), diabetes mellitus (HR = 5.792, 95% CI = 1.785 to 18.796, P = .003), and low GFR (HR = 2.943, 95% CI = 1.161, to 7.464, P = .023) were independently associated with an increase risk of MACE at long-term followup. Conclusion. Coronary angiography can be successfully performed in elderly patients with single and double vessel disease. The results in triple vessel disease are encouraging. Low LV function, diabetes, and impaired renal function increase the risk of long-term major adverse cardiac events.
Highlights
The proportion of older persons is increasing rapidly throughout the world, which projected to more than double worldwide over the half century [1]
Procedural success was obtained in 100 percent of patients with single vessel disease, in 96 percent of patients with double vessel disease, and in 75 percent of patients with triple vessel disease
Impaired left ventricular (LV) ejection fraction (hazard ratio (HR) = 0.909, 95% confidence interval (CI) = 0.856 to 0.964, P = .002), diabetes mellitus (HR = 5.792, 95% CI = 1.785 to 18.796, P = .003), and low GFR (HR = 2.943, 95% CI = 1.161, to 7.464, P = .023) were independently associated with an increase risk of major adverse cardiac events (MACE) at long-term followup
Summary
The proportion of older persons is increasing rapidly throughout the world, which projected to more than double worldwide over the half century [1]. May often make attending physicians reluctant to pursue the necessary intervention of surgery or angioplasty. Percutaneous coronary intervention (PCI) is a less invasive procedure and could be an effective alternative in these elderly patients. The elderly patient has more advanced coronary artery disease and more calcified, or even rigid and tortuous lesions. This makes coronary angioplasty technically more difficult to perform and may lead to less satisfactory results [2]. Previous reports have suggested that PCI in elderly patients is associated with a higher complication rate [3,4,5,6]. A recent systematic review and metaanalysis to evaluate the clinical outcome of patients aged 80
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