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Percutaneous coronary intervention in elderly patients: clinical benefits and challenges from single center

Ani A Rapyan1, Armine S Chopikyan2, Zinaida T Jndoyan3

  • 1Department of General and Invasive Cardiology and Internal Diseases, University Hospital 1, Yerevan State Medical University Yerevan 0025, Armenia.

American Journal of Cardiovascular Disease
|May 22, 2025
PubMed

Insights

Coronary revascularization significantly improves 3-year survival for elderly patients with acute myocardial infarction compared to conservative care. Invasive treatment also reduced cardiovascular events, though rehospitalization rates were similar.

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Interventional Cardiology

Background:

  • Elderly patients with acute myocardial infarction (AMI) face higher risks due to comorbidities and complex coronary anatomy.
  • Optimal management strategies for AMI in this demographic remain a critical clinical question.

Purpose of the Study:

  • To compare three-year outcomes of coronary revascularization versus conservative management in elderly patients with AMI.
  • To evaluate the impact of invasive treatment on survival, rehospitalization, and cardiovascular events.

Main Methods:

  • A cohort of 155 patients over 75 years old with AMI was analyzed.
  • Patients received either invasive treatment (coronary angioplasty, n=58) or conservative medical treatment (n=97).
  • Kaplan-Meier and Mantel-Cox log rank tests assessed 3-year survival, rehospitalization, and mean survival time.

Main Results:

  • Three-year survival was significantly higher in the invasive treatment group (74.1%) versus the conservative group (29.9%) (P<0.001).
  • Mean survival time was longer for invasive treatment (31.50 months) compared to conservative (24.65 months) (P<0.001).
  • Rehospitalization rates at 3 years showed a trend towards improvement with invasive treatment (34.05 months vs. 30.03 months, P=0.004).

Conclusions:

  • Coronary revascularization in elderly AMI patients reduces all-cause mortality and cardiovascular events at 3 years.
  • While rehospitalization rates were statistically similar, invasive treatment showed improved probability.
  • Coronary revascularization should be strongly considered for elderly AMI patients to improve overall survival.
Abstract

Keywords:
Elderly patientsacute myocardial infarctioncomorbid diseasescoronary angioplastymortalitypharmacologic treatmentrehospitalization

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