Complex Percutaneous Coronary Intervention Outcomes in Older Adults
Jonathan M Hanna1, Stephen Y Wang1, Ajar Kochar2,3
1Department of Internal Medicine Yale School of Medicine New Haven CT USA.
Journal of the American Heart Association
|September 30, 2023
Summary
Complex percutaneous coronary intervention (PCI) in older adults with stable ischemic heart disease showed a lower risk of target lesion revascularization. However, complex PCI was associated with a significantly higher risk of all-cause death within one year.
Area of Science:
- Cardiology
- Geriatric Medicine
- Interventional Cardiology
Background:
- Complex percutaneous coronary intervention (PCI) is increasingly common in elderly patients (≥75 years) with stable ischemic heart disease.
- Clinical outcomes for this demographic undergoing complex PCI remain understudied.
Purpose of the Study:
- To compare 12-month clinical outcomes between complex and non-complex PCI in older adults with stable ischemic heart disease.
- To assess event-free survival, all-cause death, target lesion revascularization, and bleeding events.
Main Methods:
- Retrospective cohort study of 513 patients (mean age 81 years) undergoing elective PCI.
- Comparison of outcomes between complex and non-complex PCI groups using Cox regression models.
- Analysis of 12-month event-free survival, all-cause death, target lesion revascularization, and bleeding.
Main Results:
- Complex PCI was associated with a non-significant trend towards worse event-free survival (80.4% vs. 86.8%).
- All-cause death at 1 year was significantly higher in the complex PCI group (10.2% vs. 5.9%; adjusted HR 1.97).
- Complex PCI showed a lower risk of target lesion revascularization (2.2% vs. 3.5%) but similar bleeding event rates.
Conclusions:
- In older adults with stable ischemic heart disease, complex PCI is linked to a reduced need for repeat procedures.
- Complex PCI in this population carries a significantly higher risk of 1-year all-cause mortality compared to non-complex PCI.
Keywords:
complex percutaneous coronary interventioncoronary artery diseaseolder adultsrevascularizationMore Related Videos
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