Contemporary outcome of cardiac catheterizations in 1085 consecutive octogenarians
Josef Niebauer1, Sebastian Sixt, Fuchun Zhang
1Abteilung für Innere Medizin/Kardiolgie, Universität Leipzig-Herzzentrum GmbH, Strümpellstr. 39, 04289 Leipzig, Germany. j.niebauer@medizin.uni-leipzig.de
Insights
Cardiac catheterization is safe for patients aged 80 and older, with acceptable complication rates. Age alone should not be a reason to deny these essential cardiac procedures.
Area of Science:
- Cardiology
- Geriatric Medicine
- Interventional Cardiology
Background:
- Increasing number of elderly patients (>= 80 years) require cardiac catheterization.
- Limited data exists on the safety and risks of cardiac procedures in this specific demographic.
- Need to assess procedure-related risks and identify complication predictors in octogenarians.
Purpose of the Study:
- To evaluate the safety and complication rates of cardiac catheterization in patients aged 80 years and older.
- To identify predictors of complications in this elderly population undergoing cardiac procedures.
- To challenge the notion that age alone is a contraindication for cardiac catheterization.
Main Methods:
- Retrospective study of 1085 consecutive patients aged 80 years and older.
- Analysis of 1384 cardiac catheterization procedures performed at a tertiary university hospital.
- Data collection on patient demographics, procedures performed (cardiac catheterization, percutaneous coronary interventions, coronary artery bypass surgery), and outcomes.
Main Results:
- 35% of patients underwent percutaneous coronary interventions (PCI), and 31% received coronary artery bypass surgery.
- Overall in-hospital mortality was 31 patients.
- Procedure-related complications were 2.1% after diagnostic cardiac catheterization (CATH) and 11.6% after PCI, including vascular injuries.
Conclusions:
- Cardiac catheterization in patients aged 80 and older demonstrates an acceptable complication rate.
- Age should not be the sole reason to deny patients >= 80 years access to cardiac catheterization.
- The study supports the continued use of cardiac catheterization in the elderly population when indicated.
Background:
A growing number of patients > or = 80 years require cardiac catheterization. Since little is known about the overall safety of these procedures in this population, we assessed the procedure-related risks and determined predictors for complications.
Methods:
We studied 1085 consecutive patients > or = 80 years (82.6+/-2.6 years; 526 males, 544 females), who underwent 1384 cardiac catheterizations in a tertiary specialist university hospital (3% of 43,517 procedures).
Results:
A total of 373 patients (35%) required percutaneous coronary interventions (PCI), and 331 (31%) received coronary artery bypass surgery. Thirty-one patients died during hospital stay. Procedure-related complications including vascular injuries occurred in 2.1% after CATH and 11.6% after PCI.
Conclusions:
Despite the widespread notion that cardiac catheterization exposes patients > or = 80 years to an unwarranted risk, these data demonstrate an acceptable complication rate. Patients #10878;80 years of age should thus not be refused to undergo cardiac catheterization merely based on their age.
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