Percutaneous coronary intervention in the elderly: procedural success and 1-year outcomes

Area of Science:

• Cardiology
• Geriatric Medicine
• Interventional Cardiology

Background:

• Elderly individuals experience increased morbidity following percutaneous coronary intervention (PCI) for chronic stable angina.
• Limited long-term follow-up data exists for elderly patients post-PCI.

Purpose of the Study:

• To evaluate the 1-year outcomes of elderly patients undergoing PCI compared to younger patients.
• To identify factors contributing to mortality in elderly patients post-PCI.

Main Methods:

• Retrospective review of coronary interventions performed between January 1998 and August 2001.
• Comparison of outcomes (death, revascularization, myocardial infarction) at 1 year between patients aged >=65 years and <65 years.
• Analysis controlled for ejection fraction to assess the significance of age on mortality.

Main Results:

• The study included 401 elderly subjects (mean age 73.4 years) and 479 younger subjects (mean age 55.6 years).
• No significant difference was observed in the 1-year rates of myocardial infarction or revascularization between the groups.
• Elderly patients had significantly higher in-hospital mortality (4.7% vs. 1.0%) and 1-year mortality (10.2% vs. 4.0%).
• After controlling for ejection fraction, age was no longer a significant predictor of predischarge or 1-year mortality.

Conclusions:

• Elderly patients undergoing PCI have a higher mortality risk compared to younger patients.
• This excess mortality is likely attributable to underlying comorbidities rather than procedural complications or need for revascularization.
• Age itself, when adjusted for cardiac function (ejection fraction), may not be an independent predictor of mortality post-PCI.