Outcome after Elective Percutaneous Coronary Intervention Depends on Age in Patients with Stable Coronary Artery Disease - An Analysis of Relative Survival in a Multicenter Cohort and an OCT Substudy.
Age is a strong predictor of survival in patients with coronary artery disease. In elder patients with increasing co-morbidities percutaneous coronary intervention (PCI) is associated with more complications and worse outcome. The calculation of relative survival rates adjusts for the "background" mortality in the general population by correcting for age and gender. We analyzed if elder patients after elective PCI have a worse relative survival compared to younger patient groups.



A total of 8,342 patients who underwent elective PCI at two high volume centers between 1998 and 2009 were analyzed.



The survival of our patients after PCI (observed survival) was slightly lower compared to the general population (expected survival) resulting in a slightly decreasing relative survival curve. In a multivariate Cox regression model age amongst others was a strong predictor of survival. Stratifying patients according to their age the relative survival curves of younger patients (Quartile 1: <58 years; 2,046 patients), elder patients (Quartile 3: 66-73 years; 2,090 patients) and very old patients (Quartile 4: >73 years; 2,307 patients) were similar. The relative survival of mid-aged patients (Quartile 2: 58-65 years; 1,899 patients) was better than that of all other patient groups. The profile of cardiovascular risk factors differs between the various groups resulting in different composition and burden of coronary plaques in an optical coherence tomography sub-study.



Patients after elective PCI have a slightly worse long-term survival compared to the age- and sex-matched general population. This is also true for different groups of age except for mid-aged patients between 58 and 63 years. Elder patients between 66 and 73 years and above 73 years have a similar relative survival compared to younger patients below 58 years, and might therefore have similar benefit from elective PCI.
Department of Internal Medicine II, Cardiology, Medical University of Vienna, Vienna, Austria.
Christian
C
Roth
Department of Internal Medicine II, Cardiology, Medical University of Vienna, Vienna, Austria.
Clemens
C
Gangl
Department of Internal Medicine II, Cardiology, Medical University of Vienna, Vienna, Austria.
Daniel
D
Dalos
Department of Internal Medicine II, Cardiology, Medical University of Vienna, Vienna, Austria.
Lisa
L
Krenn
Department of Internal Medicine II, Cardiology, Medical University of Vienna, Vienna, Austria.
Sabine
S
Scherzer
Department of Internal Medicine II, Cardiology, Medical University of Vienna, Vienna, Austria.
Anna
A
Gerken
Department of Internal Medicine II, Cardiology, Medical University of Vienna, Vienna, Austria.
Martin
M
Reinwein
Department of Internal Medicine II, Cardiology, Medical University of Vienna, Vienna, Austria.
Chao
C
Zhang
Section of Medical Statistics, Medical University of Vienna, Vienna, Austria.
Michael
M
Hagmann
Section of Medical Information and Retrieval Systems, Department of Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
Thomas
T
Wrba
Department of Internal Medicine II, Cardiology, Medical University of Vienna, Vienna, Austria.|Department of Internal Medicine IV, Cardiology, Hospital of Hietzing, Vienna, Austria.
Georg
G
Delle-Karth
Department of Internal Medicine II, Cardiology, Medical University of Vienna, Vienna, Austria.|Department of Internal Medicine I, Cardiology, University Hospital of Krems, Krems an der Donau, Austria.|Karl Landsteiner Private University for Health Sciences, Krems an der Donau, Austria.
Thomas
T
Neunteufl
Department of Internal Medicine II, Cardiology, Medical University of Vienna, Vienna, Austria.
Gerald
G
Maurer
Department of Internal Medicine III, Cardiology, University Hospital of St. Pölten, St. Pölten, Austria.
Paul
P
Vock
Department of Internal Medicine III, Cardiology, University Hospital of St. Pölten, St. Pölten, Austria.
Harald
H
Mayr
Department of Internal Medicine II, Cardiology, Medical University of Vienna, Vienna, Austria.|Department of Internal Medicine III, Cardiology, University Hospital of St. Pölten, St. Pölten, Austria.
Bernhard
B
Frey
Department of Internal Medicine II, Cardiology, Medical University of Vienna, Vienna, Austria.|Department of Internal Medicine I, Cardiology and Nephrology, Hospital of St. John of God, Eisenstadt, Austria.
Rudolf
R
Berger
D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D016019:Survival Analysis; D016896:Treatment Outcome