Predictors of mortality and adverse outcome in elderly high-risk patients undergoing percutaneous coronary intervention.
OBJECTIVE
We sought to identify predictors of in-hospital and long-term (> 1 year) mortality and major adverse cardiac events (MACE) in elderly patients referred for percutaneous coronary intervention (PCI).


METHODS
Seventy-three patients (> or = 80 years) were included. Clinical and interventional characteristics were collected retrospectively. Primary end points were in-hospital and long-term mortality, and a composite of non-fatal myocardial infarction, target vessel revascularization, urgent coronary artery bypass graft surgery, and death (MACE).


RESULTS
Eighty-three percent of the patients had acute coronary syndromes, 43% three-vessel disease, and 42% heart failure. In-hospital mortality and MACE were 16.4% and 19%, respectively. Long-term mortality and MACE were 11.3% and 16.4%, respectively. Univariate characteristics associated with in-hospital mortality and MACE were: Killip Class III-IV, heart failure, cardiogenic shock, TIMI 0-2 flow prior and after intervention, diabetes mellitus, contrast nephropathy, and presence of A-V block or atrial fibrillation (AF). Long term predictors for mortality were the presence of heart failure, cardiogenic shock, diabetes mellitus, TIMI flow 0-2 before and after intervention, and A-V block or AF.


CONCLUSIONS
The identification of the factors previously mentioned may help to predict complications in elderly patients.
The National Institute of Cardiology, Mexico City.
Emma
E
Miranda Malpica
Marco Antonio
MA
Peña Duque
José
J
Castellanos
Emilio
E
Exaire
Oscar
O
Arrieta
Eduardo
E
Salazar Dávila
Ramón
R
Villavicencio Fernández
Hilda
H
Delgadillo-Rodríguez
Carlos J
CJ
González-Quesada
Marco A
MA
Martínez-Ríos
D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000401:mortality*; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors