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The effects of percutaneous coronary intervention on mortality in elderly patients with non-ST-segment elevation

Pınar D Gündoğmuş1, Emrah B Ölçü2, Ahmet Öz2

  • 1Medical Doctor, Department of Cardiology, 29 Mayıs State Hospital, Ankara/Turkey.

Scottish Medical Journal
|August 11, 2020
PubMed

Insights

Percutaneous coronary intervention effectively reduces one-year mortality in elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI). This finding supports PCI as a valuable treatment strategy for this demographic, despite current underutilization.

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Interventional Cardiology

Background:

  • Elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI) are recommended for invasive revascularization assessment.
  • Current guidelines suggest PCI for NSTEMI, yet elderly patients receive fewer interventions.
  • This disparity highlights a need to evaluate PCI's effectiveness in older NSTEMI populations.

Purpose of the Study:

  • To assess the effectiveness of percutaneous coronary intervention (PCI) on all-cause mortality in elderly patients with NSTEMI.
  • To compare outcomes between conservative management and PCI in this patient group.
  • To identify predictors of mortality in older NSTEMI patients undergoing different treatment strategies.

Main Methods:

  • A cohort of 324 NSTEMI patients aged 65 or older was analyzed.
  • Patients were treated with either a conservative strategy or percutaneous coronary intervention (PCI).
  • Demographic, clinical characteristics, and one-month and one-year follow-up data were collected and analyzed.

Main Results:

  • 64.19% of patients underwent PCI, while 35.81% received conservative treatment.
  • PCI was found to be an independent predictor of reduced one-year mortality (HR: 1.965).
  • Killip class ≥2, reduced Left Ventricular Ejection Fraction, and renal failure independently predicted one-year mortality.

Conclusions:

  • Percutaneous coronary intervention (PCI) demonstrates effectiveness in reducing one-year mortality for NSTEMI patients over 65.
  • PCI is a viable strategy to decrease mortality in this elderly population.
  • Larger population studies are recommended to further validate these findings and inform clinical practice.
Abstract

Keywords:
Acute coronary syndromeconservative treatmentelderly, mortalitynon-ST-segment elevation myocardial infarctionpercutaneous coronary intervention

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