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. 2009 Dec 14;32(12):E16–E21. doi: 10.1002/clc.20596

Percutaneous Coronary Interventions in Nonagenarians: In‐Hospital Mortality and Outcome at One Year Follow‐up

Rupen Parikh 1, Srinivas Chennareddy 3, Vincent DeBari 2, Aiman Hamdan 1, Donna Konlian 1, Fayez Shamoon 3, Mahesh Bikkina 1,
PMCID: PMC6652868  PMID: 20014200

Abstract

Background

Limited information is available regarding outcome of very elderly patients referred for percutaneous coronary intervention (PCI).

Purpose

This study aimed to assess acute and intermediate term clinical outcomes among nonagenarians.

Methods

The study included 32 consecutive nonagenarian patients undergoing PCI between January 2001 to August 2006. There were 6 (19%) patients admitted with acute ST‐segment elevation myocardial infarction (STEMI), 10 (31%) patients with non‐STEMI, and 16 (50%) patients with unstable angina pectoris. Receiver‐operator characteristic curve (ROC) analysis was done to define the relationship between heart rate, blood pressure, left ventricle ejection fraction, serum creatinine level, and mortality.

Results

Results: Immediate procedure success was achieved in 28 (88%) patients. Cumulative mortality at hospital discharge was 3(9%), at 6 months it was 6 (19%) and remained 6(19%) at 1 year follow‐up.

Conclusion

Hypotension and low ejection fraction correlated with in‐hospital mortality and worst clinical outcome. Procedural success does not appear to decline in nonagenarians. Copyright © 2009 Wiley Periodicals, Inc.

Full Text

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References

  • 1. Keller NM, Feit F. Atherosclerotic heart disease in the elderly. Curr Opin Cardiol 1995; 10: 427–433. [DOI] [PubMed] [Google Scholar]
  • 2. Foot DK, Lewis RP, Pearson TA, Beller GA. Demographics and cardiology, 1950–2050. J Am Coll Cardiol 2000; 35: 1067–1081. [DOI] [PubMed] [Google Scholar]
  • 3. Raleigh VS. Trends in world population: how will the millennium compare with the past. Hum Reprod Update 1999; 5: 500–505. [DOI] [PubMed] [Google Scholar]
  • 4. Bathcelor WB, Jollis JG, Friesinger GC. The challenge of health care delivery to the elderly patient with cardiovascular disease. Cardiology Clinics 1999; 17(1): 1–17. [DOI] [PubMed] [Google Scholar]
  • 5.US Census Bureau: 2006 Population Estimates, General demographic Characteristics. Available at www.factfinder.census.gov. Last accessed on August 28, 2008.
  • 6. Waller BF, Roberts WC. Cardiovascular disease in the very elderly: analysis of necropsy patients aged 90 years or over. Am J Cardiol 1983; 51: 403–421. [DOI] [PubMed] [Google Scholar]
  • 7. Alexander KP, Anstrom KJ, Muhlbaier LH, et al. Outcomes of cardiac surgery in patient age 80 years: results from the National Cardiovascular Network. J Am Coll Cardiol 2000; 35(3): 731–738. [DOI] [PubMed] [Google Scholar]
  • 8. Engoren M, Arslanian‐Engoren C, Steckel D, Neihardt J, Fenn‐Buderer N. Cost, outcome, and functional status in octogenarians and septuagenarians after cardiac surgery. Chest 2002; 122(4): 1309–1315. [DOI] [PubMed] [Google Scholar]
  • 9. Barnett SD, Halpin LS, Speir AM, et al. Postoperative complications among octogenarians after cardiovascular surgery. Ann Thorac Surg 2003; 76(3): 726–731. [DOI] [PubMed] [Google Scholar]
  • 10.Australian Institute of Health and Welfare (AIHW) 1998.. Australian Hospital Statistics 1996–1997. Health Services Series No. 11. AIHW Cat, No. HSE 5. Canberra: AIHW. [Google Scholar]
  • 11. Abizaid AS, Mintz GS, Saucedo JF, et al. Influence of patient age on acute and late clinical outcome following Palmaz‐Schatz coronary stent implantation. Am J Cardiol 2000; 85: 338–343. [DOI] [PubMed] [Google Scholar]
  • 12. Taddai CF, Weintraub WS, Douglas JS Jr, et al. Influence of age on outcome after percutaneous transluminal coronary angioplasty. Am J Cardiol 1999; 84: 245–251. [DOI] [PubMed] [Google Scholar]
  • 13. Pepine CJ, Allen HD, Bashore TM, et al. ACC/AHA guidelines for cardiac catheterization and cardiac catheterization laboratories. ACC/AHA Ad Hoc Task Force on Cardiac Catheterization. Circulation 1991; 84: 2213–2247. [DOI] [PubMed] [Google Scholar]
  • 14. Chesebro JH, Knatterud G, Roberts R, et al. Thrombolysis in myocardial infarction (TIMI) trial, phase I: a comparison between intravenous tissue plasminogen activator and intravenous streptokinase. Clinical findings through hospital discharge. Circulation 1987; 76: 142–154. [DOI] [PubMed] [Google Scholar]
  • 15. Roach GW, Kanchuger M, Mangano CM, et al. Adverse cerebral outcomes after coronary bypass surgery. Multicenter Study of Perioperative Ischemia Research Group and the Ischemia Research and Education Foundation Investigators. N Engl J Med 1996; 335(25): 1857–1863. [DOI] [PubMed] [Google Scholar]
  • 16. Batchelor WB, Anstrom KJ, Muhlbaier LH, et al. Percutaneous interventional outcomes in octogenarians: Insight from the National Cardiovascular Network Database (abstract) Circulation 1997; 96: 1–10. [Google Scholar]
  • 17. Kern MJ, Deligonul U, Galan K, et al. Percutaneous transluminal coronary angioplasty in octogenarians. Am J Cardiol 1988; 61: 457–458. [DOI] [PubMed] [Google Scholar]
  • 18. Rizo‐Patron C, Hamad N, Paulus R, Garcia J, Beard E. Percutaneous transluminal coronary angioplasty in octogenarians with unstable coronary syndromes. Am J Cardiol 1990; 66: 857–858. [DOI] [PubMed] [Google Scholar]
  • 19. Thompson RC, Holmes DR Jr, Gersh BJ, Mock MB, Bailey KR. Percutaneous transluminal coronary angioplasty in the elderly: early and long‐time results. J Am Coll Cardiol 1991; 17: 1245–1250. [DOI] [PubMed] [Google Scholar]
  • 20. Santana JO, Haft JI, LaMarche NS, Goldstein JE. Coronary angioplasty in patients eighty years of age or older. Am Heart J 1992; 124: 13–18. [DOI] [PubMed] [Google Scholar]
  • 21. Berg JM, Bal ET, Gin TG, et al. Initial and long‐term results of percutaneous transluminal coronary angioplasty in patients 75 years of age and older. Am J Cardiol 1996; 77: 690–695. [DOI] [PubMed] [Google Scholar]
  • 22. Little T, Milner MR, Lee K, Constantine J, Pichard AD, Lindsay J Jr. Late outcome and quality of life following percutaneous transluminal coronary angioplasty in octogenarians. Cathet Cardiovasc Diag 1993; 29: 261–266. [DOI] [PubMed] [Google Scholar]
  • 23. Rozenman Y, Mossery M, Lotan C, Hasin Y, Gotsman MS. Percutaneous transluminal coronary angioplasty in octogenarians. Am J Geriat Cardiol 1995; 4: 38–41. [PubMed] [Google Scholar]
  • 24. Hochman JS, Sleeper LA, Webb JG, et al. Early revascularization in actue myocardial infarction complicated by cardiogenic shock. SHOCK investigators. Should we emergently revascularize occluded coronaries for cardiogenic shock N Engl J Med 1999; 341: 625–634. [DOI] [PubMed] [Google Scholar]

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