Affiliation:
1. Department of Cardiology Japanese Red Cross Ashikaga Hospital Ashikaga Japan
2. Duke Clinical Research Institute Duke University Medical Center Durham NC
3. Department of Cardiology Keio University School of Medicine Tokyo Japan
4. Department of Cardiology Nagoya University Graduate School of Medicine Nagoya Japan
5. Department of Cardiology Kokura Memorial Hospital Kitakyushu Japan
6. Department of Cardiology Kawasaki Medical School Kurashiki Japan
7. Department of Cardiology Kurashiki Central Hospital Kurashiki Japan
8. Department of Cardiology Aichi Medical University Nagakute Japan
9. Division of Cardiovascular Medicine Toho University Ohashi Medical Center Tokyo Japan
Abstract
Background
Scarce data exist about the outcomes after percutaneous coronary intervention (
PCI
) in old patients. This study sought to provide an overview of
PCI
in elderly patients, especially nonagenarians, in a Japanese large prospective nationwide registry.
Methods and Results
We analyzed 562 640 patients undergoing PCI (≥60 years of age) from 1018 Japanese hospitals between 2014 and 2016 in the J‐PCI (Japanese percutaneous coronary intervention) registry. Among them, 10 628 patients (1.9%), including 6780 (1.2%) with acute coronary syndrome (
ACS
) and 3848 (0.7%) with stable coronary artery disease, were ≥90 years of age. We investigated differences in characteristics and in‐hospital outcomes among sexagenarians, septuagenarians, octogenarians, and nonagenarians. Older patients were more frequently women and had a greater frequency of heart failure and chronic kidney disease than younger patients. In addition, older patients had a higher rate of in‐hospital mortality, cardiac tamponade, cardiogenic shock after
PCI
, and bleeding complications requiring blood transfusion. Nonagenarians had the highest risk of in‐hospital mortality (odds ratio, 3.60; 95%
CI
, 3.10–4.18 in
ACS
; odds ratio
,
6.24; 95%
CI,
3.82–10.20 in non‐
ACS
) and bleeding complications (
odds ratio,
1.79; 95%
CI,
1.35–2.36 in
ACS
; odds ratio
,
2.70; 95%
CI,
1.68–4.35 in non‐
ACS
) when referenced to sexagenarians. More important, transradial intervention was an inverse independent predictor of both in‐hospital mortality and bleeding complications.
Conclusions
Older patients, especially nonagenarians, carried a greater risk of in‐hospital death and bleeding compared with younger patients after
PCI
. Transradial intervention might contribute to risk reduction for periprocedural complications in elderly patients undergoing
PCI
.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
53 articles.
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