[Predictors of one-year outcomes after percutaneous coronary interventions in octogenarian patients with acute coronary syndrome.]
L S Kokov1,2, A Y Vanyukov3, K Y Berezhnoi2,3
1N.V.Sklifosovsky Scientific-Research Emergency Institute, 3, Bolshaya Sukharevskaya sq., Moscow, 129090, Russian Federation.
Insights
Octogenarian patients with acute coronary syndrome undergoing percutaneous coronary intervention (PCI) showed good long-term outcomes. Drug-eluting stents, radial access, and GP IIb/IIIa use improved survival in ST-elevation myocardial infarction patients.
Area of Science:
- Cardiology
- Geriatric Medicine
- Interventional Cardiology
Background:
- Acute coronary syndrome (ACS) in octogenarians presents unique challenges.
- Long-term outcomes and predictors of mortality in this elderly population are crucial for treatment strategies.
Purpose of the Study:
- To evaluate the long-term clinical outcomes of coronary stenting in octogenarian patients with ACS.
- To identify predictors of two-year mortality in this cohort.
Main Methods:
- Retrospective analysis of 366 octogenarian patients with STEMI, NSTEMI, or unstable angina.
- Patients underwent percutaneous coronary intervention (PCI).
- Median follow-up was 20 months.
Main Results:
- Hospital mortality was 8%, with a long-term mortality of 21%.
- Independent predictors of mortality included chronic renal failure, cardiogenic shock, multi-vessel coronary disease, ejection fraction <35%, and left main coronary artery lesions.
- Drug-eluting stent (DES) use, radial access, and GP IIb/IIIa use were associated with better outcomes in ST-segment elevation myocardial infarction (STEMI) patients.
Conclusions:
- Percutaneous coronary interventions in octogenarian patients with ACS are associated with favorable clinical and long-term outcomes.
- Progression of cardiac and renal failure were primary causes of death.
- Specific interventions like DES, radial access, and GP IIb/IIIa use may improve survival in STEMI patients.
Abstract:
Our study presented the long-term outcomes of coronary stenting and predictors of two-year outcomes in octogenarian patients with acute coronary syndrome. A total of 366 patients with STEMI, NSTEMI and unstable angina undergoing percutaneous coronary intervention (PCI). Results were assessed at a median follow up of 20 months. Hospital mortality in the group of patients older than 80 years was 8% and long-term mortality 21%. Chronic renal failure, cardiogenic shock, multi-vessel coronary disease, ejection fraction less than 35, left main coronary artery lesion were independent predictors of mortality. The best prognosis corresponded to those drug-eluting stents use, radial access and GP IIb/IIIa use in patients with ST-segment elevation myocardial infarction. Progression of cardiac and renal failure were the main causes of death during this period. Our results suggested that percutaneous coronary interventions in octogenarian patients with acute coronary syndrome was associated with good clinical and long-term outcomes. DES use, radial access and GP IIb/IIIa use in patients with ST-segment elevation myocardial infarction were associated with improved all-cause mortality in our population.
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