Medium- to long-term outcomes in percutaneous coronary intervention in the very elderly population

BackgroundAs the population ages and life expectancy increases, there is increasing demand for percutaneous coronary intervention (PCI) in patients over 80-years-old. Long-term outcomes in these patients are less predictable than younger patients. The aim of this study is to present long-term outcomes in patients ≥ 80-years-old following PCI.MethodsFrom our registry database, patients ≥ 80-years-old who had successful or unsuccessful PCI procedure were identified. Patients selected for coronary intervention had no known immediate non-cardiac life-threatening disease.ResultsOne hundred and fifty-one consecutive patients ≥ 80-years-old underwent PCI from May 2006 to June 2010 were identified. The mean age was 83 ± 3 years and 58% (n = 87) were male. The mean follow-up was 48 ± 26 months. Indications for PCI were unstable angina in 27%, non-ST-elevation myocardial infarction (NSTEMI) in 43%, ST-elevation myocardial infarction (STEMI) in 18% and stable angina in 12%. Metallic stents were successfully deployed in 93% of patients, 4% received balloon angioplasty only. PCI was unsuccessful in 3% of the cases. The cumulative MACE rate during follow-up was 54%, including 11% myocardial infarction (MI), 7% repeated revascularization, 46% death. The Kaplan-Meier 1- and 5-years overall and MACE-free survival was 85%, 55% and 77%, 45%, respectively. One in five patients would be re-admitted to cardiology within the first year: severe aortic stenosis was a strong predictor (P < 0.01).ConclusionIn the very elderly population without immediate major life-threatening co-morbidity, PCI can be performed with a high expectation of procedural success and a excellent 1-year survival and an expected 5-year survival which compares favourably with age matched individuals.