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Association of age with adverse events following coronary atherectomy during percutaneous coronary intervention

Dae Yong Park1, Jiun-Ruey Hu2, Sean DeAngelo3

  • 1Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA.

Journal of Geriatric Cardiology : JGC
|July 3, 2025
PubMed

Insights

Coronary atherectomy outcomes worsen with increasing age, with older adults experiencing higher mortality and complications like gastrointestinal hemorrhage and acute kidney injury. Risks increase stepwise with age, highlighting the need for careful consideration in elderly patients.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Geriatric Medicine

Background:

  • Severely calcified coronary artery lesions are common in older adults.
  • Coronary atherectomy is a treatment option for these lesions.
  • The impact of coronary atherectomy in older adults remains understudied.

Purpose of the Study:

  • To evaluate the impact of coronary atherectomy on older adults.
  • To compare outcomes across different age groups undergoing atherectomy.
  • To assess in-hospital mortality and postprocedural complications.

Main Methods:

  • Analysis of inpatient PCI data from 2016-2023 (Vizient Clinical Data Base).
  • Comparison of outcomes in younger adults (<65) and older adults (65-74, 75-84, ≥85).
  • Primary outcome: in-hospital mortality; Secondary outcomes: postprocedural complications.

Main Results:

  • Older adults (58.0%) had higher in-hospital mortality, gastrointestinal hemorrhage (GIH), acute kidney injury (AKI), tamponade, and pericardiocentesis compared to younger adults.
  • Risks increased stepwise with age: youngest-old (65-74), middle-old (75-84), and oldest-old (≥85).
  • Significant interaction between atherectomy and age groups for in-hospital mortality (P=0.035).

Conclusions:

  • Coronary atherectomy is associated with increased in-hospital mortality and complications in older adults.
  • The risk of adverse outcomes escalates with advancing age.
  • Age is a critical factor influencing outcomes after coronary atherectomy.
Abstract

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