Impact of age on the prognostic value of left ventricular function in relation to procedural outcomes following percutaneous coronary intervention: Insights from the <scp>B</scp>ritish cardiovascular intervention society

Kwok, Chun Shing; Anderson, Simon; Mcallister, Katherine; Sperrin, Matthew; Keavney, Bernard; Nolan, James; Myint, Phyo Kyaw; Zaman, Azfar; Buchan, Iain; Ludman, Peter; Belder, Mark de; Mamas, Mamas A.

doi:10.1002/ccd.25732

Cited by 11 publications

(11 citation statements)

References 30 publications

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“…The fastest growing age group in the United State is the elderly . Elderly patients are particularly predisposed to developing calcified plaques, have worse baseline clinical risk factors including worse left ventricular function, and are turned down for surgical and percutaneous revascularization more frequently than younger patients . The 30‐day MACCE rate was 2.2% in elderly patients and was identical to the younger patients, even though the elderly group had nearly twice the number of patients who presented with MI.…”

Section: Discussionmentioning

confidence: 99%

Outcomes in Elderly Patients With Severely Calcified Coronary Lesions Undergoing Orbital Atherectomy

Lee

Shlofmitz

Lluri

et al. 2017

J Interven Cardiology

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Section: Discussionmentioning

confidence: 99%

Outcomes in Elderly Patients With Severely Calcified Coronary Lesions Undergoing Orbital Atherectomy

Lee

Shlofmitz

Lluri

et al. 2017

J Interven Cardiology

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“…This analysis suggested that depressed left ventricular function is an important independent predictor of worse 30-day mortality outcomes across all age groups [20]. Other large studies on consecutive patients undergoing PCI confirmed that predictors other than old age may have a greater influence on outcomes, and that risk stratification of PCI patients should take into account kidney injury, anemia, and low left ventricular function [17,18].…”

Section: Outcomes Of Percutaneous Coronary Intervention In the Elderlymentioning

confidence: 81%

Coronary artery bypass grafting in octogenarians

Nicolini¹

2015

Current Opinion in Cardiology

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It is not the case that CABG is indicated only when there are contraindications to PCI. CABG confers more benefit than PCI in patients with increasing baseline cardiac risk, in the absence of serious systemic diseases that can reasonably reduce their life expectancy.CABG and PCI, with proper selection, should be considered complementary rather than competitive procedures in the therapy of octogenarians affected by coronary artery disease.

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“…This cohort differs from previous work, which has focused on the impact of LVEF in specific ACS syndromes 28 or in those who underwent revascularisation only. 5,29…”

Section: Discussionmentioning

confidence: 99%

Effect of age on the prognostic value of left ventricular function in patients with acute coronary syndrome: A prospective registry study

Kwok

Bachmann

Mamas

et al. 2016

European Heart Journal: Acute Cardiovascular Care

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Objective: This study aims to study the prognostic impact of LV function on mortality and examine the effect of age on the prognostic value of left ventricular function. Methods:We examined the Myocardial Ischaemia National Audit Project (MINAP) registry (2006)(2007)(2008)(2009)(2010) data with a mean follow up of 2.1 years. LV function was categorized into good (ejection fraction (EF) ≥50%), moderate (EF 30-49%) and poor (EF <30%) categories. Coxproportional hazards models were constructed to examine the prognostic significance of LV function in different age groups (<65, 65-74, 75-84 and ≥85 years) on all-cause mortality adjusting for baseline variables.Results: Of 424,848 patients, LV function data available for 123,609. Multiple imputations were used to impute missing values of LV function and the final sample for analyses were drawn from 414,305. After controlling for confounders, 339,887 participants were included in the regression models. For any age group, mortality was higher with worsening degree of LV impairment. Increased age reduced the adverse prognosis associated with reduced LV function (hazard ratios (HRs) of death comparing poor LV function to good LV function were 2.11 95%CI 1.88-2.37 for age <65 years and 1.28 95%CI 1.20-1.36 for age ≥85 years.Older patients had a high mortality risk even in those with good LV function. HRs of mortality for ≥85 compared to <65 years (HR=1.00) within good, moderate and poor ejection fractions groups were 5.89, 4.86 and 3.43, respectively. Conclusions:In patients with ACS, clinicians should interpret the prognostic value of LV function taking into account patient's age.3

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Impact of age on the prognostic value of left ventricular function in relation to procedural outcomes following percutaneous coronary intervention: Insights from the British cardiovascular intervention society

Abstract: Our analysis suggests that worsening LV function is an important independent predictor of worse 30-day mortality outcomes across all age groups and underscores the need for a measure of LV function in all patients for accurate risk stratification prior to PCI.

Cited by 11 publications

References 30 publications

Outcomes in Elderly Patients With Severely Calcified Coronary Lesions Undergoing Orbital Atherectomy

Outcomes in Elderly Patients With Severely Calcified Coronary Lesions Undergoing Orbital Atherectomy

Coronary artery bypass grafting in octogenarians

Effect of age on the prognostic value of left ventricular function in patients with acute coronary syndrome: A prospective registry study

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