In-Hospital Outcomes of Percutaneous Coronary Intervention for octogenarians/nonagenarians: Insights from the NCDR Cath-PCI Registry
Presenter
Evangelia Vemmou, MD, Minneapolis Heart Institute® - Abbott Northwestern Hospital, Minneapolis, MN
Evangelia Vemmou, MD1, Ilias Nikolakopoulos, M.D.1, Judit Karacsonyi, MD, PhD1, Christian Schmidt, MS2, Ross Garberich, MS, MBA3, Mario Goessl, M.D., FSCAI4, Paul Sorajja, M.D., FSCAI1, Ivan J. Chavez, M.D., FSCAI1, Michael R. Mooney, M.D., FSCAI1, Jay H. Traverse, M.D., FSCAI5, Yale L. Wang, M.D., FSCAI6, Santiago Garcia, M.D., FSCAI7, Anil K. Poulose, M.D., FSCAI8, M. Nicholas Burke, M.D.1, Bavana V Rangan, BDS, MPH3 and Emmanouil S. Brilakis, MD, PhD, FSCAI1, (1)Minneapolis Heart Institute® - Abbott Northwestern Hospital, Minneapolis, MN, (2)Minneapolis Heart Institute, Minneapolis, MN, (3)Minneapolis Heart Institute Foundation, Minneapolis, MN, (4)Abbott Northwestern Hospital, Minneapolis, MN, (5)Minneapolis Cardiology Associates, Minneapolis, MN, (6)Minneapolis Heart Institute® - Abbott Northwestern Hospital, Mendota Heights, MN, (7)The Christ Hospital Health Network, Cincinnati, OH, (8)Minneapolis Cardiology Associates, Bloomington, MN
Keywords: Acute Coronary Syndromes (ACS) and Coronary
Background
The outcomes of percutaneous coronary interventions (PCI) in octogenarians/nonagenarians have received limited study.
Methods
We compared in-hospital outcomes of PCI between patients ≥80 vs. <80-years-old in 15,624 PCIs performed in 10,278 patients between 2014 and 2019 in a tertiary center in the United States.
Results
There were 1675 octogenarians and nonagenarians in our study (16.3% of the total population). PCI for acute coronary syndromes was more common in octo- and nonagenarians compared with younger patients (71.9% vs. 63.2%), p<0.001). Compared with younger patients, octo- and nonagenarians were less likely to be men (60.1% vs. 74.8%, p<0.001) and more likely to have a history of myocardial infarction (39.7% vs. 35.3%, p<0.001), hypertension (89.2% vs. 76.3%, p<0.001) and stroke (25.4% vs. 13.8%, p<0.001). They were more likely to have a history of coronary bypass grafts surgery (21.9% vs. 16.5%, p<0.001) and less likely to have ever smoked (19.7% vs. 35.9%, p<0.001). There was no difference in the percentage of complex lesions in the ≥80 group compared with the <80 group (55.2% vs. 55.6%, p=0.26) but octogenarians and nonagenarians had shorter lesions (16 [12, 26] vs. 17 [12, 28] mm, p<0.001). The octogenarians/nonagenarians had lower technical success 93.4% vs. 94.8%, p=0.002) and higher incidence of in-hospital major adverse cardiovascular events (MACE) (6% vs. 4.1%, p<0.001) (
Figure).
Conclusions
PCI is feasible in octogenarians and nonagenarians, although success rates are lower and complication rates are higher compared with younger patients.
