Comparison of Outcomes of Percutaneous Coronary Interventions in Patients of Three Age Groups (&lt;60, 60 to 80, and &gt;80 Years) (from the New York State Angioplasty Registry†)†This study was performed with the permission of the New York State Department of Health, which retains ownership of the Registry.

Feldman, Dmitriy N.; Gade, Christina; Slotwiner, Alexander J.; Parikh, Manish; Bergman, Geoffrey; Wong, S. Chiu; Minutello, Robert M.

doi:10.1016/j.amjcard.2006.06.026

Cited by 141 publications

(94 citation statements)

References 27 publications

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“…Given the relative frequency and the overall complexity of coronary bifurcation lesions, many works have addressed this topic, focusing mainly on stenting techniques, and BMS vs. DES use [17][18][19]. Moreover, many authors have investigated age in large cohorts of patients undergoing PCI, reporting it to be an independent predictor of both in-hospital and long-term mortality [7,20,21]. However, few data are available on outcome in patients receiving treatment for coronary bifurcation lesions stratified by age.…”

Section: Discussionmentioning

confidence: 99%

Early and long-term outlook of percutaneous coronary intervention for bifurcation lesions in young patients

Roversi

Biondi‐Zoccai

Romagnoli

et al. 2013

International Journal of Cardiology

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Background: Coronary artery disease is most common in older patients, but may occur in younger subjects. The outlook of young patients after percutaneous coronary intervention (PCI) of challenging lesion subsets such as coronary bifurcations, is not established. We thus aimed to appraise the early and long-term results of PCI for bifurcations in young patients. Methods: A multicenter, retrospective study was conducted enrolling consecutive patients undergoing bifurcation PCI between 2002 and 2006 in 22 Italian centers. Patients were divided in 2 groups: age ≤45 years, and age >45 years. The primary end-point was long-term rate of major adverse cardiac events (MACE). Results: 4,314 patients were included: 195 (4.5%) in the younger group, and 4119 (95.5%) in the older group. 30-day outcomes did not show significant differences in MACE rates, with 1.0% in the ≤45 years group and 2.1% in the >45 years group (p=0.439), with death in 0.5% and 1.2% (p=0.388). At long-term follow-up (24.4± 15.1 months), younger patients showed similar rates of MACE, (12.8% vs. 16.6%, p=0.161), myocardial infarction (3.1% vs. 3.7%, p=0.633), target lesion revascularization (11.3% vs. 12.5%, p =0.627), or stent International Journal of Cardiology xxx (2012) xxx-xxx ☆ All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

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Section: Discussionmentioning

confidence: 99%

Early and long-term outlook of percutaneous coronary intervention for bifurcation lesions in young patients

Roversi

Biondi‐Zoccai

Romagnoli

et al. 2013

International Journal of Cardiology

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“…[12][13][14] In the "Prevention of Ischemic Complications (EPIC)" study, 15 older age was an independent risk factor for vascular complications and bleeding related to the puncture site after femoral approach. Although the use of arterial closure devices may reduce the incidence of problems after the femoral approach, elderly patients still have a higher rate of vascular complications.…”

Section: Discussionmentioning

confidence: 99%

Intervenção coronária percutânea por acesso transradial em pacientes idosos vs. não-idosos

Dall'Orto¹,

Lopes²,

Alcântara³

et al. 2013

Rev. Bras. Cardiol. Invasiva

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background: Radial access is the object of increasing interest for interventional cardiologists, providing several advantages, including a reduction of bleeding and major adverse cardiovascular event (MACE) rates. However, even though elderly patients have a greater risk of access site bleedings, the use of the radial approach is controversial, due to the greater anatomical complexity of these patients. Methods: Retrospective study including patients undergoing percutaneous coronary intervention (PCIs) using the radial access divided into an elderly (> 65 years) and a non-elderly (< 65 years) group. Clinical, angiographic and procedural characteristics as well as early and late follow-up outcomes were analyzed. results: The elderly group included 131 patients (145 PCIs) and the non-elderly group, 149 patients (176 PCIs). The elderly group presented lower body mass index and fewer smokers and higher rates of chronic renal failure, peripheral arterial disease, stable coronary artery disease, multivessel disease and calcified lesions. There was no difference in the rate of access-site crossover (4.8% vs. 3.4%), fluoroscopy time (15.3 ± 10.3 minutes vs. 16.1 ± 10.3 minutes), procedure time (40.6 ± 26.4 minutes vs 46.4 ± 53.6 minutes), angiographic (96.3% vs 97.5%) and clinical (94.5% vs 95.4%) success, MACE (3.4% vs 3.4%) and bleedings (0.21% vs 0.6%) during hospitalization. In the late follow-up there was no difference in the MACE rates (9.6% vs 11%). Conclusions: Despite the greater clinical and angiographic complexity, PCI using the radial access is safe and effective, with a high procedural success rate and low in-hospital and late follow-up complication rates.

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“…28 But they are also at high risk of procedural complications and post-procedural bleeding due to longstanding hypertension, peripheral atherosclerosis and other severe pre-procedural comorbidities. [10][11][12][13] Several comparisons have been conducted between TRI and TFI in elderly patients. [14][15][16][17][18] The present one, based on the propensity score IPW method, showed that the rate of MACE in elderly patients underwent TRI were significantly lower than TFI.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, they are also reported to have a higher risk of access siterelated complications and post-procedural bleeding. [10][11][12][13] So far several studies have evaluated the safety and efficacy of TRI in elderly patients, [14][15][16][17][18] but none of them have taken the economic consequences into consideration. Using data from the Fuwai PCI database, a single-center registry from the largest heart center in the People's Republic of China, we sought to compare both hospital costs and clinical outcomes between TRI and TFI in elderly patients aged over 65 years.…”

Section: Chinese Medical Sciences Journal September 2017mentioning

confidence: 99%

中国老年患者经桡动脉与股动脉介入治疗比较

Jin

Qiao

et al. 2017

cmsj

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Objective To compare hospital costs and clinical outcomes between transradial intervention (TRI) and transfemoral intervention (TFI) in elderly patients aged over 65 years.Methods We identified 1229 patients aged over 65 years who underwent percutaneous coronary intervention (PCI) in Fuwai Hospital, Beijing, China, between January 1 and December 31, 2010. Total hospital costs and in-hospital outcomes were compared between TRI and TFI. An inverse probability weighting (IPW) model was introduced to control potential biases.Results Patients who underwent TRI were younger, less often female, more likely to receive PCI for single-vessel lesions, and less likely to undergo the procedure for ostial lesions. TRI was associated with a cost saving of CNY7495 (95%CI: CNY4419-10 420). Such differences were mainly driven by lower PCI-related costs. TRI patients had shorter length of stay (1.9 days, 95%CI: 1.1-2.7 days), shorter post-procedural stay (0.7 days, 95%CI: 0.3-1.1 days), and fewer major adverse cardiac events (adjusted odds ratio = 0.47, 95%CI: 0.31-0.73). There was no statistical significance in the incidence of post-PCI bleeding between TRI and TFI (P>0.05). Such differences remained consistent in clinically relevant subgroups of acute myocardial infarction, acute coronary syndrome, and stable angina.Conclusion The use of TRI in patients aged over 65 years was associated with significantly reduced hospital costs and more favorable clinical outcomes.

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Cited by 141 publications

References 27 publications

Early and long-term outlook of percutaneous coronary intervention for bifurcation lesions in young patients

Early and long-term outlook of percutaneous coronary intervention for bifurcation lesions in young patients

Intervenção coronária percutânea por acesso transradial em pacientes idosos vs. não-idosos

中国老年患者经桡动脉与股动脉介入治疗比较

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