title: Comparison of outcomes of patients ≥ 80 years of age having percutaneous coronary intervention according to presentation (stable vs unstable angina pectoris/non-ST-segment elevation myocardial infarction vs ST-segment elevation myocardial infarction).
abstract: Patients ≥ 80 years old with coronary artery disease constitute a particular risk group in relation to percutaneous coronary intervention (PCI). From 2002 through 2008 we examined the annual proportion of patients ≥ 80 years old undergoing PCI in western Denmark, their indications for PCI, and prognosis. From 2002 through 2009 all elderly patients treated with PCI were identified in a population of 3.0 million based on the Western Denmark Heart Registry. Cox regression analysis was used to compare mortality rates according to clinical indications controlling for potential confounding. In total 3,792 elderly patients (≥ 80 years old) were treated with PCI and the annual proportion increased from 224 (5.4%) in 2002 to 588 (10.2%) in 2009. The clinical indication was stable angina pectoris (SAP) in 30.2%, ST-segment elevation myocardial infarction (STEMI) in 35.0%, UAP/non-STEMI in 29.7%, and "ventricular arrhythmia or congestive heart failure" in 5.1%. Overall 30-day and 1-year mortality rates were 9.2% and 18.1%, respectively. Compared to patients with SAP the adjusted 1-year mortality risk was significantly higher for patients presenting with STEMI (hazard ratio 3.86, 95% confidence interval 3.08 to 4.85), UAP/non-STEMI (hazard ratio 1.95, 95% confidence interval 1.53 to 2.50), and ventricular arrhythmia or congestive heart failure (hazard ratio 2.75, 95% confidence interval 1.92 to 3.92). In patients with SAP target vessel revascularization decreased from 7.1% in 2002 to 2.5% in 2008. In conclusion, the proportion of patients ≥ 80 years old treated with PCI increased significantly over an 8-year period. Patients with SAP had the lowest mortality rates and rates of clinically driven target vessel revascularization decreased over time.
authors: Department of Cardiology, Odense University Hospital, Odense, Denmark. dr_lissie@hotmail.com
authors: Lisbeth
authors: L
authors: Antonsen
authors: Lisette Okkels
authors: LO
authors: Jensen
authors: Per
authors: P
authors: Thayssen
authors: Evald Høj
authors: EH
authors: Christiansen
authors: Anders
authors: A
authors: Junker
authors: Hans-Henrik
authors: HH
authors: Tilsted
authors: Christian Juhl
authors: CJ
authors: Terkelsen
authors: Anne
authors: A
authors: Kaltoft
authors: Michael
authors: M
authors: Maeng
authors: Knud Noerregaard
authors: KN
authors: Hansen
authors: Jan
authors: J
authors: Ravkilde
authors: Jens Flensted
authors: JF
authors: Lassen
authors: Morten
authors: M
authors: Madsen
authors: Henrik Toft
authors: HT
authors: Sørensen
authors: Leif
authors: L
authors: Thuesen
mesh_terms: D000369:Aged, 80 and over; D060050:Angina, Stable / Q000401:mortality* / Q000628:therapy; D000789:Angina, Unstable / Q000401:mortality* / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data* / Q000639:trends; D001145:Arrhythmias, Cardiac / Q000401:mortality; D015331:Cohort Studies; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000401:mortality* / Q000628:therapy*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000401:mortality; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy; D012042:Registries; D012044:Regression Analysis