An evaluation of octogenarians undergoing percutaneous coronary intervention from the Melbourne Interventional Group registry.
OBJECTIVE
The objective of this study was to evaluate the clinical characteristics and outcomes of octogenarians (> or =80 years of age) in a contemporary, multi-centre percutaneous coronary intervention (PCI) registry.


BACKGROUND
Octogenarians are increasingly referred for PCI. This patient population frequently has significant comorbidities, which result in major therapeutic challenges.


METHODS
The study population consisted of consecutive patients undergoing PCI in seven major Australian hospitals, who were treated over a 2-year period (2004-2005).


RESULTS
Of 4,360 PCI's, 11.3% (n = 491) were performed in octogenarians and 88.7% (n = 3,869) in patients <80 years. Octogenarians (compared with patients <80 years of age) were more likely female and have greater comorbidities such as cerebrovascular disease, renal impairment, congestive heart failure, and chronic airway disease. Octogenarians more frequently presented with acute coronary syndromes and cardiogenic shock. Octogenarians had significantly increased 30-day (6.0 vs. 1.4%, P < 0.01) and 12-month mortality (8.4% vs. 2.5%, P < 0.01), and major adverse cardiac event rates [(MACE), 30 days 11.3% vs. 5.4%, P < 0.01 and 12-months 18.7% vs. 12.9%, P = 0.04]. Cardiogenic shock, ST-segment elevation myocardial infarction, chronic renal failure, and age > or =80 years were independent predictors of 12-month mortality.


CONCLUSIONS
Octogenarians comprise a significant cohort of patients undergoing PCI. Octogenarians have more comorbidities, and higher rates of mortality and MACE, mandating thorough clinical evaluation before acceptance for PCI.
Department of Cardiology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Bryan P
BP
Yan
Ronen
R
Gurvitch
Stephen J
SJ
Duffy
David J
DJ
Clark
Martin
M
Sebastian
Gishel
G
New
Roderick
R
Warren
Jeffery
J
Lefkovits
Robert
R
Lew
Angela L
AL
Brennan
Chris
C
Reid
Nick
N
Andrianopoulos
Andrew E
AE
Ajani
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality; D003324:Coronary Artery Disease / Q000401:mortality / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006299:Health Services for the Aged; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000150:complications; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D018579:Patient Selection; D012042:Registries; D012107:Research Design; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014739:Victoria