title: Retrospective multicenter observational study of the interventional management of coronary disease in the very elderly: the NINETY.
abstract: OBJECTIVE
  The aim of this observational, multicenter study was to describe the outcome of very elderly patients undergoing percutaneous coronary intervention (PCI).
  
  
  BACKGROUND
  There is a paucity of data among nonagenarians undergoing PCI.
  
  
  METHODS
  All consecutive patients 90 years of age or older undergoing PCI with stent implantation between April 2002 and June 2009 were included in the study. The primary endpoint was the long-term rate of net adverse cardiac events (NACE), that is, death, myocardial infarction (MI), target lesion revascularization, and life-threatening or major bleedings.
  
  
  RESULTS
  One hundred forty-six nonagenarians were divided in three groups according to clinical setting: 27 (group A) stable angina or silent ischemia, 85 (group B) unstable angina or non-ST elevation MI, and 34 (group C) with ST elevation MI (STEMI). At 30 days, the incidence of NACE was significantly lower in patients in Group A vs. B or C (0% vs. 17.3% vs. 31.2%, P = 0.006), and the frequency of definite stent thrombosis was higher in Group C vs. A or B (9.4% vs. 0% vs. 0%, P = 0.007), respectively. Up to a median follow-up of 24 months, NACE rate was 33.3% in group A, 49.3% in group B, and 50% in group C (P = 0.32). There were no significant differences between groups in the individual components of the primary endpoint.
  
  
  CONCLUSIONS
  PCI in nonagenarians is safe and feasible with acceptable major bleeding rates. However, long-term results show high mortality rates particularly in the STEMI group.
authors.affiliation: Division of Interventional Cardiology, University of Turin, Turin, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Sillano
authors.forename: Chiara
authors.initials: C
authors.lastname: Resmini
authors.forename: Emanuele
authors.initials: E
authors.lastname: Meliga
authors.forename: Giacomo
authors.initials: G
authors.lastname: Boccuzzi
authors.forename: Andrea
authors.initials: A
authors.lastname: Zuffi
authors.forename: Emanuele
authors.initials: E
authors.lastname: Barbato
authors.forename: Julian
authors.initials: J
authors.lastname: Gunn
authors.forename: Matthew
authors.initials: M
authors.lastname: Price
authors.forename: Fiorenzo
authors.initials: F
authors.lastname: Gaita
authors.forename: Imad
authors.initials: I
authors.lastname: Sheiban
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D060050:Angina, Stable / Q000401:mortality / Q000628:therapy; D000789:Angina, Unstable / Q000401:mortality / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D023903:Coronary Restenosis / Q000401:mortality; D005060:Europe; D005260:Female; D006470:Hemorrhage / Q000401:mortality; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013927:Thrombosis / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States