In-Hospital Clinical Outcomes of Elderly Patients (≥80 Years) Undergoing Percutaneous Coronary Intervention

• DOI: 10.1253/circj.cj-14-0129
• Publication Date: 2014-03-25T12:41:58Z
• Authors: Takashi Miura; Yusuke Miyashita; Hirohiko Motoki; Kentaro Shimada; Masanori Kobayashi; Hiroyuki Nakajima; Hikaru Kimura; Hiroshi Akanuma; Eiichiro Mawatari; Toshio Sato; Shoji Hotta; Yuichi Kamiyoshi; Takuya Maruyama; Noboru Watanabe; Takayuki Eisawa; Shinichi Aso; Shinichiro Uchikawa; Naoto Hashizume; Noriyuki Sekimura; Takehiro Morita; Soichiro Ebisawa; Atsushi Izawa; Takeshi Tomita; Jun Koyama; Uichi Ikeda
• Keywords: Aged, 80 and over; Male; Coronary Artery Disease; Middle Aged; 3. Good health; 03 medical and health sciences; Percutaneous Coronary Intervention; 0302 clinical medicine; Risk Factors; Humans; Female; Hospital Mortality; Prospective Studies; Aged

The clinical outcomes of elderly patients (≥80 years old) undergoing percutaneous coronary intervention (PCI) has not been well established, despite recent advances in both devices and techniques.We recruited patients from the SHINANO Registry, a prospective, observational, multicenter, cohort study. From August 2012 to July 2013, a total of 1,923 consecutive patients with 2,250 elective/urgent PCIs (2,105 admissions) (mean age, 71±11 years; ≥80 years, 23%; men, 77%) were enrolled. The primary endpoint was procedural success. The secondary endpoints were in-hospital death and in-hospital major adverse cardiovascular events (MACE). The procedural success rate was significantly lower (83.7% vs. 89.1%, P=0.0001), and the rates of in-hospital mortality and MACE were significantly higher in elderly than in non-elderly patients (3.6% vs. 1.5%, P=0.005; 4.4% vs. 2.3%, P=0.016, respectively). For elective PCI, the rates of procedural success and in-hospital MACE were similar between groups (90.3% vs. 91.3%, P=0.65, 2.3% vs. 1.2%, P=0.2, respectively). On multivariate analysis, being elderly was not an independent predictor of procedural failure (OR, 1.15; CI, 0.81-1.61; P=0.43).In elderly patients, PCI is safe and feasible. The presence of comorbidities is a more important factor than age alone.