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Effect of Age on Clinical Outcomes in Elderly Patients (>80 Years) Undergoing Percutaneous Coronary Intervention: Insights From a Multi-Centre Australian PCI Registry.
- Source :
-
Heart, Lung & Circulation . Jul2021, Vol. 30 Issue 7, p1002-1013. 12p. - Publication Year :
- 2021
-
Abstract
- <bold>Objectives: </bold>To evaluate the effect of age in an all-comers population undergoing percutaneous coronary intervention (PCI).<bold>Background: </bold>Age is an important consideration in determining appropriateness for invasive cardiac assessment and perceived clinical outcomes.<bold>Methods: </bold>We analysed data from 29,012 consecutive patients undergoing PCI in the Melbourne Interventional Group (MIG) registry between 2005 and 2017. 25,730 patients <80 year old (78% male, mean age 62±10 years; non-elderly cohort) were compared to 3,282 patients ≥80 year old (61% male, mean age 84±3 years; elderly cohort).<bold>Results: </bold>The elderly cohort had greater prevalence of hypertension, diabetes and previous myocardial infarction (all p<0.001). Elderly patients were more likely to present with acute coronary syndromes, left ventricular ejection fraction <45% and chronic kidney disease (p<0.0001). In-hospital, 30-day and long-term all-cause mortality (over a median of 3.6 and 5.1 years for elderly and non-elderly cohorts, respectively) were higher in the elderly cohort (5.2% vs. 1.9%; 6.4% vs. 2.2%; and 43% vs. 14% respectively, all p<0.0001). In multivariate Cox regression analysis, estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2 (HR 3.8, 95% CI: 3.4-4.3), cardiogenic shock (HR 3.0, 95% CI: 2.6-3.4), ejection fraction <30% (HR 2.5, 95% CI: 2.1-2.9); and age ≥80 years (HR 2.8, 95% CI: 2.6-3.1) were independent predictors of long-term all-cause mortality (all p<0.0001).<bold>Conclusion: </bold>The elderly cohort is a high-risk group of patients with increasing age being associated with poorer long-term mortality. Age, thus, should be an important consideration when individualising treatment in elderly patients. [ABSTRACT FROM AUTHOR]
- Subjects :
- *VENTRICULAR ejection fraction
*OLDER patients
*PERCUTANEOUS coronary intervention
*TREATMENT effectiveness
*MORTALITY
*ACUTE coronary syndrome
*LEFT heart ventricle
*RESEARCH
*RESEARCH methodology
*MEDICAL care
*ACQUISITION of data
*MEDICAL cooperation
*EVALUATION research
*CARDIOVASCULAR system
*COMPARATIVE studies
*HEART physiology
*STROKE volume (Cardiac output)
Subjects
Details
- Language :
- English
- ISSN :
- 14439506
- Volume :
- 30
- Issue :
- 7
- Database :
- Academic Search Index
- Journal :
- Heart, Lung & Circulation
- Publication Type :
- Academic Journal
- Accession number :
- 150616300
- Full Text :
- https://doi.org/10.1016/j.hlc.2020.12.003