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Related Experiment Video

Updated: May 3, 2026

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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Percutaneous coronary intervention in nonagenarians.

Matti Riihiniemi1, Jarkko Piuhola1,2, Matti Niemelä1,2

  • 1Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu, University of Oulu, Oulu, Finland.

Scandinavian Cardiovascular Journal : SCJ
|June 2, 2025
PubMed
Summary

Percutaneous coronary intervention (PCI) in nonagenarians is safe and effective, especially for stable coronary artery disease. Early mortality is linked to ST-elevation myocardial infarction (STEMI), but overall outcomes are acceptable for selected elderly patients.

Keywords:
Coronary artery diseasePCIcoronary catheterizationnonagenarianpercutaneous coronary intervention

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Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Interventional Cardiology

Background:

  • Nonagenarians (patients aged 90 years and older) are increasingly undergoing percutaneous coronary intervention (PCI).
  • The safety and efficacy of PCI in this specific elderly demographic remain under-researched.
  • Aging populations necessitate understanding treatment outcomes in the very elderly.

Purpose of the Study:

  • To investigate the characteristics and outcomes of nonagenarians undergoing PCI.
  • To evaluate the safety and efficacy of PCI in nonagenarians presenting with different coronary artery disease (CAD) conditions.
  • To determine the primary outcome of one-year mortality and secondary outcomes including bleeding, myocardial infarction, stroke, and repeat revascularization.

Main Methods:

  • A retrospective study of 107 nonagenarians (mean age 91.2 years) who underwent PCI between 2012 and 2022.
  • Patients were stratified into three groups: ST-elevation myocardial infarction (STEMI), non-ST-elevation acute coronary syndrome (NSTEACS), and stable coronary artery disease (CAD).
  • One-year mortality was the primary endpoint, with secondary endpoints including in-hospital major bleeding and 1-year rates of myocardial infarction, stroke, and repeat revascularization.

Main Results:

  • The majority of patients presented with acute coronary syndrome (STEMI: 32.7%, NSTEACS: 47.7%), while 19.6% had stable CAD.
  • Early mortality was significantly higher in STEMI patients (in-hospital: 22.9%, 30-day: 34.3%) compared to NSTEACS and stable CAD groups.
  • One-year mortality did not differ significantly between the groups (40.0% vs. 27.5% vs. 19.0%), with 1-year rates for MI, stroke, and repeat revascularization at 7.5%, 1.9%, and 3.7%, respectively. Major in-hospital bleeding occurred in 3.7% of patients.

Conclusions:

  • Excess mortality in nonagenarians undergoing PCI is primarily associated with ST-elevation myocardial infarction (STEMI) due to early adverse events.
  • The observed mortality rates in this study are comparable to the general population, suggesting PCI is a viable option for carefully selected nonagenarians.
  • Percutaneous coronary intervention (PCI) can be considered a safe and effective treatment for selected nonagenarian patients with coronary artery disease.