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Published on: December 16, 2022

In-hospital outcomes of contemporary percutaneous coronary interventions in the very elderly

Olga Dynina1, Babak A Vakili, James N Slater

  • 1Department of Medicine (Cardiology), Albert Einstein College of Medicine, Bronx, New York 10003, USA.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|February 21, 2003
PubMed

Insights

Very elderly patients (≥85 years) undergoing percutaneous coronary intervention (PCI) experienced higher rates of stroke and renal failure. However, advanced age alone was not an independent predictor of in-hospital mortality, suggesting PCI is a viable option.

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Interventional Cardiology

Background:

  • Coronary heart disease (CHD) is a leading cause of mortality in the elderly.
  • Limited data exist on percutaneous coronary intervention (PCI) outcomes in the very elderly (≥85 years) despite advancements in treatments.
  • This study addresses the knowledge gap regarding PCI in this specific demographic.

Purpose of the Study:

  • To evaluate the clinical characteristics and outcomes of very elderly patients (≥85 years) undergoing PCI.
  • To compare outcomes in the very elderly versus younger patient cohorts.
  • To determine if advanced age is an independent predictor of mortality after PCI.

Main Methods:

  • Analysis of a large, contemporary, multi-institutional PCI database.
  • Inclusion of prospectively collected data from five New York City metropolitan area hospitals.
  • Data collected from January 1, 1998, to October 1, 1999, encompassing 10,847 patients.

Main Results:

  • The very elderly cohort (2.6% of patients) had higher incidences of post-PCI stroke and renal failure requiring dialysis compared to younger patients.
  • In-hospital mortality was significantly higher in the very elderly (2.5%).
  • Multivariate analysis revealed that age ≥85 years was not an independent predictor of in-hospital mortality (OR = 1.22).

Conclusions:

  • Very elderly patients undergoing PCI face increased risks of specific complications like stroke and renal failure.
  • Despite higher raw mortality rates, advanced age alone should not be a contraindication for PCI in patients ≥85 years.
  • PCI can be a safe and effective treatment option for carefully selected very elderly individuals with coronary heart disease.

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