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Percutaneous coronary intervention in patients aged 80 years old and above: a systematic review and meta-analysis

Norman H Lin1, Jamie S-Y Ho2, Andie Hartanto Djohan1

  • 1Department of Cardiology, National University Heart Centre, Singapore.

Asiaintervention
|December 9, 2022
PubMed

Insights

Elderly patients (80+) undergoing percutaneous coronary intervention (PCI) face high mortality risks. This study found significant rates of death and major adverse cardiac events (MACE) within 3 years post-PCI, highlighting the need for further research.

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Interventional Cardiology

Background:

  • Ischaemic heart disease is a leading global cause of death.
  • Elderly patients (80+ years) undergoing percutaneous coronary intervention (PCI) have elevated risks of mortality and complications due to age, frailty, and comorbidities.

Purpose of the Study:

  • To evaluate the overall outcomes for patients aged 80 years and above who undergo PCI.
  • To analyze mortality and major adverse cardiac events (MACE) in this high-risk demographic.

Main Methods:

  • A systematic review and meta-analysis of studies involving patients aged 80+ undergoing PCI for any indication.
  • Databases searched include PUBMED, EMBASE, SCOPUS, and CENTRAL.
  • Pooled outcomes included all-cause death, cardiac death, in-hospital death, stroke/transient ischaemic attack (TIA), myocardial infarction (MI), congestive cardiac failure (CCF), and MACE.

Main Results:

  • The study analyzed data from 2,566,004 patients.
  • Pooled cumulative incidences: 19.22% all-cause death, 7.78% cardiac death, 7.16% in-hospital death, 1.54% stroke/TIA, 3.58% MI, 4.74% CCF, and 17.51% MACE.
  • Three-year mortality reached 33.27%. ST-elevation MI patients showed higher in-hospital death and 1-year mortality rates compared to non-ST-elevation MI patients.

Conclusions:

  • Senior patients aged 80 and above experience high mortality rates at 1 and 3 years post-PCI, irrespective of the indication.
  • These findings underscore the critical need for further investigation into the management and outcomes of this vulnerable patient group.
Abstract

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