In-hospital outcomes and mortality in octogenarians after percutaneous coronary intervention

Abstract

Background: There is systematic growth in the number of number of elderly patients treated with percutaneous coronary intervention (PCI); however, little is known about PCI results in the very elderly (long-lived) patients aged 85 years and above.

Aim: To assess the demographic, clinical, and angiographic findings in patients aged > 85 years (GER), undergoing PCI, compared with younger patients treated in the year 2012.

Methods: This was a single centre retrospective study based on a consecutive group of 920 patients with coronary disease (stable and acute coronary syndrome [ACS]). Patients were divided into two groups: GER aged 85 years and over (n = 82) and controls (CG) below 85 years (n = 838).

Results: The mean age in the GER group was 88.6 vs. 66.7 years in the CG. There were more females in the GER group (57% vs. 29%) than in the CG (p < 0.001). The indication for PCI was mainly ACS in GER (65%) vs. CG (50%) including ST segment elevation myocardial infarction (STEMI) 30% vs. 29% (p = NS), ACS non-STEMI 35% vs. 20% (p = 0.01). GER patients had more comorbidities and more advanced multivessel coronary artery disease. The ratio of procedural success was lower in GER compared to CG. The incidence of in-hospital death was higher in GER (4.8%) compared to CG (0.83%); the most common complication in GER group was contrast-induced nephropathy (18.2% vs. 6.2%). Major adverse cardiovascular events were significantly more frequent in GER patients with ACS compared to CG patients with the same diagnosis.

Conclusions: Patients > 85 years old, especially with ACS undergoing PCI, are at greater risk of in-hospital complications, especially contrast-induced nephropathy and procedural complications, compared to younger patients.