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[Comparison of outcomes after transradial intervention in patients of different age groups]
Sheng-wen Liu1, Shu-bin Qiao, Bo Xu
1Coronary Heart Disease Center, Peking Union Medical College, Beijing 100037, China.
Insights
Transradial intervention (TRI) shows favorable outcomes in younger and older patients with coronary artery disease. However, octogenarians face substantially higher risks of major adverse cardiac events (MACE) after TRI.
Area of Science:
- Cardiology
- Interventional Cardiology
- Geriatric Cardiology
Background:
- Transradial intervention (TRI) is a common approach for coronary artery disease (CAD).
- Patient age is a critical factor influencing clinical outcomes after cardiovascular interventions.
- Understanding age-related risks in TRI is essential for optimizing patient care.
Purpose of the Study:
- To compare in-hospital clinical outcomes of patients with CAD undergoing TRI across different age groups: <65 years, 60-79 years, and ≥80 years (octogenarians).
- To identify predictors of major adverse cardiac events (MACE) following TRI in these age cohorts.
Main Methods:
- A retrospective analysis of 16,293 patients who underwent TRI between May 2004 and May 2009.
- In-hospital outcomes were compared across three age groups: younger (<65), older (60-79), and octogenarians (≥80).
- Multivariable logistic regression was used to determine predictors of in-hospital MACE (death, myocardial infarction, target vessel revascularization).
Main Results:
- Angiographic success rates were similar across all age groups (97.5%–98.1%).
- Procedural complications, in-hospital MACE (1.3%–7.5%), and mortality (0.1%–2.9%) increased significantly with age.
- Independent predictors of MACE included age ≥80, prior myocardial infarction, left main lesion, age 65-79, number/length of stents, and use of drug-eluting stents (DES).
Conclusions:
- Younger and older patients (<80 years) undergoing TRI generally experience favorable in-hospital outcomes.
- Octogenarians (≥80 years) exhibit a substantially higher risk of in-hospital MACE after TRI.
- Age is a significant predictor of adverse events following transradial intervention.
Objective:
To compare the in-hospital clinical outcome of patients with coronary artery disease in different age groups [< 65 years (younger), 60 to 79 years (older), and ≥ 80 years (octogenarians)] underwent transradial intervention (TRI) so asto analyze the predictors of adverse events.
Method:
From May 2004 to May 2009, a total of 16 293 patients underwent transradial intervention at our institution. The in-hospital outcome for patients in different age groups after TRI was investigated. Multivariable logistic regression analysis was performed to determinate the predictors of in-hospital major adverse cardiac events (MACE) (composed of death, myocardial infarction or target vessel revascularization).
Results:
Angiographic success rates were not different (97.5%, 97.4%, 98.1%, P > 0.05) between 3 groups. However, the rates of procedural complications became progressively higher with age group (0.8%, 1.2%, 4.0%, P < 0.01). In-hospital MACE (1.3% vs 2.2% vs 7.5%, P < 0.01) and mortality (0.1% vs 0.3% vs 2.9%, P < 0.01) increased incrementally with age group. Aad it was associated with a significant decrement of DES (92.0%, 89.6%, 57.3%, P < 0.01). The following characteristics were identified as independent multivariate predictors of in-hospital major adverse cardiac events: age ≥ 80 (OR 6.26, 95%CI: 3.33 to 11.74; P < 0.01), prior myocardial infarction (OR 2.19, 95%CI: 1.66 to 2.88; P < 0.01), left main lesion (OR 2.02, 95%CI: 1.04 to 3.91; P = 0.04), age of 65 to 79 (OR 1.83, 95%CI: 1.37 to 2.43; P < 0.01), number of implanted stents (OR 1.31, 95%CI: 1.15 to 1.50; P < 0.01), total stented length (OR 1.01, 95%CI: 1.01 to 1.02; P = 0.03), and use of DES (OR 0.59, 95%CI: 0.39 to 0.89; P = 0.01).
Conclusions:
The younger and older patients undergoing TRI have a more favorable in-hospital outcome. However the octogenarians has a substantially higher risk of in-hospital MACE.
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