Trends in the association between age and in-hospital mortality after percutaneous coronary intervention: National
Mandeep Singh1, Eric D Peterson, Matthew T Roe
1Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn 55905, USA. singh.mandeep@mayo.edu
Insights
In-hospital mortality after percutaneous coronary intervention (PCI) decreased across all age groups studied. The most significant absolute reduction in mortality was observed in patients aged 80 and older.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Geriatric Cardiology
Background:
- Limited data exist on how patient age affects outcomes of percutaneous coronary interventions (PCI).
- Assessing in-hospital mortality across different age strata is crucial for understanding PCI impact.
- The National Cardiovascular Data Registry provides a valuable resource for this analysis.
Purpose of the Study:
- To evaluate the impact of patient age on in-hospital mortality following PCI.
- To analyze temporal trends in PCI outcomes stratified by age.
- To identify age-related differences in PCI outcomes.
Main Methods:
- Analysis of 1,410,069 patients undergoing PCI from January 1, 2001, to December 31, 2006.
- Patients were stratified into four age groups: <40, 40-59, 60-79, and ≥80 years.
- In-hospital mortality rates were compared across age groups and analyzed for temporal trends.
Main Results:
- Overall in-hospital mortality was 1.22%, with rates of 0.60%, 0.59%, 1.26%, and 3.16% for age groups <40, 40-59, 60-79, and ≥80, respectively (P<0.0001).
- Significant temporal improvements in adjusted in-hospital mortality were observed in the 60-79 and ≥80 age groups.
- The greatest absolute reduction in mortality occurred in patients aged 80 and older.
Conclusions:
- In-hospital mortality after PCI has decreased over a six-year period for all age demographics.
- Despite overall improvements, older patients, particularly those ≥80 years, experienced the largest absolute decline in mortality.
- Age remains a significant factor influencing PCI outcomes, with elderly patients benefiting most from recent improvements.
Background:
Temporal trends and contemporary data characterizing the impact of patient age on in-hospital outcomes of percutaneous coronary interventions are lacking. We sought to determine the importance of age by assessing the in-hospital mortality of stratified age groups in the National Cardiovascular Data Registry.
Methods And Results:
In-hospital mortality after percutaneous coronary intervention on 1 410 069 patients was age stratified into 4 groups-group 1 (age <40, n=25 679), group 2 (40 to 59, n=496 204), group 3 (60 to 79, n=732 574), and group 4 (>or=80, n=155 612)-admitted from January 1, 2001, to December 31, 2006. Overall in-hospital mortality was 1.22%; in-hospital mortality was 0.60%, 0.59%, 1.26%, and 3.16% in groups 1 to 4, respectively, P<0.0001. Overall temporal improvement per calendar year in the adjusted in-hospital mortality after percutaneous coronary intervention was noted in most groups; however, this finding was significant only in the 2 older age groups, group 3 (odds ratio, 0.94; 95% CI, 0.92 to 0.96) and group 4 (odds ratio, 0.95; 95% CI, 0.92 to 0.97). The absolute mortality reduction was greatest in the most elderly group, those over the age of 80 years.
Conclusions:
In-hospital mortality after percutaneous coronary intervention has fallen for all age groups over the past 6 years. However, the largest absolute reduction was seen among patients 80 years of age or older.
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