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Percutaneous coronary intervention in the elderly: changes in case-mix and periprocedural outcomes in 31,758 patients

Cathy Johnman1, Keith G Oldroyd, Danny F Mackay

  • 1Public Health, University of Glasgow, United Kingdom.

Circulation. Cardiovascular Interventions
|July 8, 2010
PubMed

Insights

Elderly patients undergoing percutaneous coronary intervention (PCI) face higher complication risks. However, despite an increase in elderly PCI procedures, complication rates have remained stable over time.

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Interventional Cardiology

Background:

  • The elderly population is growing, with a high prevalence of coronary heart disease.
  • Percutaneous coronary intervention (PCI) is a primary revascularization method for older adults.
  • Investigating age-related risks and temporal trends in PCI complications is crucial.

Purpose of the Study:

  • To assess if periprocedural complication risk is higher in elderly patients (age ≥75) undergoing PCI.
  • To determine if this risk has changed over time.
  • To analyze trends in PCI utilization among the elderly.

Main Methods:

  • Retrospective cohort study using the Scottish Coronary Revascularization Register (2000-2007).
  • Inclusion of 31,758 patients undergoing non-emergency PCI.
  • Comparison of complication rates between elderly and younger patients, and analysis of trends over the study period.

Main Results:

  • PCI procedures in elderly patients increased significantly from 8.7% to 13.9% between 2000 and 2007.
  • Elderly patients presented with more complex conditions: multivessel disease, comorbidities, and prior cardiac events.
  • The 30-day major adverse cardiovascular event rate was higher in the elderly (4.5%) compared to younger patients (2.7%).

Conclusions:

  • Elderly patients undergoing PCI have a higher risk of periprocedural complications.
  • Despite an increasing proportion of elderly patients receiving PCI, the risk of complications has not significantly changed over time.
  • This suggests that current PCI practices are managing the increased complexity in elderly patients effectively.
Abstract

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