In-hospital outcomes of contemporary percutaneous coronary interventions in the very elderly.
Coronary heart disease is the leading cause of death among the elderly (> 65 years) and the very elderly (> 85 years). Little information is available regarding the outcome of very elderly patients referred for PCI in the current era of improved techniques, devices, and pharmacotherapy. The objective of the current study was to evaluate the clinical characteristics and outcomes of very elderly patients > or = 85 years of age in a large, contemporary, multi-institutional PCI database. Five hospitals in the New York City metropolitan area contributed these prospectively defined data elements on consecutive patients undergoing PCI from 1 January 1998 to 1 October 1999. Of 10,847 patients, 5,341 (49%) were younger than 65 years, 3,342 (31%) were 65-74 years, 1,885 (17%) were 75-84 years, and 279 (2.6%) were at least 85 years of age. Following PCI, the very elderly developed stroke (P < 0.001) and renal failure requiring dialysis (P = 0.002) more commonly than younger patients following PCI. The very elderly had a significantly increased in-hospital mortality rate at 2.5% (P < 0.001). However, on multivariate analysis, age > or = 85 years was not an independent predictor of in-hospital mortality (OR = 1.22; 95% CI = 0.37-4.07). The very elderly should not be refused PCI on the basis of advanced age alone.
Dynina
Olga
O
Department of Medicine (Cardiology), Albert Einstein College of Medicine, Bronx, New York 10003, USA.
Vakili
Babak A
BA
Slater
James N
JN
Sherman
Warren
W
Ravi
Kumar L
KL
Green
Stephen J
SJ
Sanborn
Timothy A
TA
Brown
David L
DL
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000401:mortality / Q000706:statistics & numerical data*; D003324:Coronary Artery Disease / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy*; D019992:Databases as Topic / Q000706:statistics & numerical data; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011183:Postoperative Complications; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors