An evaluation of octogenarians undergoing percutaneous coronary intervention from the Melbourne Interventional Group registry

Yan, Bernard; Gurvitch, Ronen; Duffy, Stephen J.; Clark, David; Sebastian, Martin; New, Gishel; Warren, R.; Lefkovits, J.; Lew, Robert; Brennan, A.; Reid, Christopher M.; Andrianopoulos, Nick; Ajani, A.

doi:10.1002/ccd.21303

Cited by 40 publications

(42 citation statements)

References 27 publications

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“…We reported a clear trend for increasing mortality and MACE in elderly patients undergoing PCI in an emergent setting, consistent with previous studies [3], [23]. In our study mortality following primary PCI was 18.2% and MACE 22.7%, although the absolute numbers in both cohorts were small (only 2.5% of all procedures in patients younger than 85 years, and 5.5% of those aged 85 years and older), explained by the absence of a 24Â7 primary PCI program at our center until mid-2008.…”

Section: Discussionsupporting

confidence: 89%

“…Despite this, the in-hospital mortality rate in the very elderly remained several fold higher than that of younger patients, a finding that persisted in the propensity matched populations. This observed rate is higher than those reported in the registry studies of National Cardiovascular Network (3.8%) [8], American College of Cardiology/National Cardiovascular Data Registry (3.77%) [9], and the Melbourne Interventional Group (4.1%) [23]. However, the octogenarians in these registries were ''younger'' than our patient cohort, with an average age less than 85 years.…”

Section: Discussioncontrasting

confidence: 84%

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In‐hospital outcomes of very elderly patients (85 years and older) undergoing percutaneous coronary intervention

Appleby

Ivanov

Mackie

et al. 2011

Cathet Cardio Intervent

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Very elderly patients represent a high-risk cohort, with significantly increased in-hospital mortality and complication rates after PCI. Death occurred predominantly in very elderly patients undergoing nonelective PCI. Decisions to proceed with PCI in very elderly patients should be based on other prognostic variables in combination with advanced age, and these patients should not be excluded from revascularization based on age alone.

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Section: Discussionsupporting

confidence: 89%

Section: Discussioncontrasting

confidence: 84%

In‐hospital outcomes of very elderly patients (85 years and older) undergoing percutaneous coronary intervention

Appleby

Ivanov

Mackie

et al. 2011

Cathet Cardio Intervent

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“…However, the rates observed in our study are similar to that of previous findings. 4,15,19,20 This may be secondary to the lack of adjustment for differing pharmacokinetics and the increased risk of vascular injury in elderly patients.…”

Section: Discussionmentioning

confidence: 99%

Outcome of Contemporary Percutaneous Coronary Intervention in the Elderly and the Very Elderly: Insights From the Blue Cross Blue Shield of Michigan Cardiovascular Consortium

Thomas

Moscucci

Smith

et al. 2011

Clinical Cardiology

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Background: There is a paucity of data on the outcome of contemporary percutaneous coronary intervention (PCI) in the elderly. Accordingly, we assessed the impact of age on outcome of a large cohort of patients undergoing PCI in a regional collaborative registry. Hypothesis: Increasing age is associated with a higher incidence of procedural-related complications. Results: Of the cohort, 64.64% were <70 years of age, 23.83% were 70 to 79 years, 7.85% were 80 to 84 years, 3.09% were 85 to 89 years, and 0.58% were 90 years or older. Increasing age was associated with an increase in all-cause in-hospital mortality, contrast-induced nephropathy, transfusion, stroke/transient ischemic attack, and vascular complications. The overall in-hospital mortality rate was 1.09% and increased from 0.67% in those younger than 70 years up to 5.44% in those 90 years old or greater. The mortality rate in patients over 80 years approached 12% to 15% for those with ST-segment myocardial infarction and 39% in cardiogenic shock patients. Conclusions: The proportion of elderly patients referred for PCI is increasing. Procedural complications increase with age, and patients presenting with unstable symptoms are at the highest risk.

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“…10 Chama a atenção o fato de que um terço dos pacientes tinha idade > 75 anos, e a idade é preditora independente de ECCAM em vários estudos e registros. 11,12 Quanto aos fatores de risco para aterosclerose, a hipertensão arterial foi o mais frequente, incidindo em 72,4% da população do estudo, estando em consonân-cia com a literatura 5,7,10 e constituindo-se, nesta aná-lise, em preditor de ECCAM, ao lado do diabetes melito.…”

Section: Resultsunclassified

Intervenção coronária percutânea no hospital Vera Cruz de Campinas: resultados de cinco anos de experiência

Gioppato¹,

Cantarelli²,

Conforti³

et al. 2011

Rev. Bras. Cardiol. Invasiva

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Background: Percutaneous coronary intervention (PCI) plays an important role in the treatment of coronary artery disease, as a result of technological development and its wide application in different clinical scenarios of greater complexity. We present data from a cath lab that started its activity five years ago at a private hospital in the city of Campinas (SP). Methods: From 2006 to 2011, 518 consecutive patients were submitted to PCI at the Vera Cruz Hospital and were included in this study. Clinical, angiographic and procedural characteristics and the in-hospital clinical outcomes were analyzed. Results: Patient average age was 65.8 + 12.2 years, 73.5% were male, 29.9% were diabetics and half of procedures were performed during an acute coronary syndrome. A total of 890 lesions (74% B2/C type) were treated with 1.6 stents/patient, 37.1% of them were drug eluting stents. Stent diameter and length were 3.01 + 0.53 mm and 23.2 + 7 mm, respectively. The procedure success was 93.6%, death occurred in 2.9% of the patients, stroke in 0.8%, myocardial infarction in 3.5%, reintervention in 0.8% and stent thrombosis in 0.97%. Hypertension [odds ratio (OR) 4.48, 95% confidence interval (95% CI) 1.32-15.16; P = 0.016] and diabetes (OR 7.24, 95% CI 1.69-31.05; P = 0.008) were independent predictors of in-hospital major adverse cardiac and cerebrovascular events (MACCE). Conclusions: The overall procedural success and low incidence of MACCE demonstrated the efficacy and safety of PCI in the daily clinical practice in a new interventional cardiology service, localized in a hospital outside the capital of the state of São Paulo.

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An evaluation of octogenarians undergoing percutaneous coronary intervention from the Melbourne Interventional Group registry

Abstract: Octogenarians comprise a significant cohort of patients undergoing PCI. Octogenarians have more comorbidities, and higher rates of mortality and MACE, mandating thorough clinical evaluation before acceptance for PCI.

Cited by 40 publications

References 27 publications

In‐hospital outcomes of very elderly patients (85 years and older) undergoing percutaneous coronary intervention

In‐hospital outcomes of very elderly patients (85 years and older) undergoing percutaneous coronary intervention

Outcome of Contemporary Percutaneous Coronary Intervention in the Elderly and the Very Elderly: Insights From the Blue Cross Blue Shield of Michigan Cardiovascular Consortium

Intervenção coronária percutânea no hospital Vera Cruz de Campinas: resultados de cinco anos de experiência

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