Rotational atherectomy in octogenarians/nonagenarians increased 1-year MACE to 20% compared to 13% in younger patients, with adjusted HR 1.78 (95% CI 1.27-2.50, p=0.001).
Observational (n=785)
No
Does advanced age (≥80 years) worsen in-hospital and 1-year clinical outcomes in patients with severely calcified coronary lesions treated with rotational atherectomy compared to younger patients?
Rotational atherectomy is a feasible and safe adjunctive strategy for percutaneous coronary intervention in octogenarians and nonagenarians, with short-term adverse outcomes comparable to younger patients, though 1-year mortality remains higher due to advanced age and comorbidities.
Effect estimate: adj. HR 1.78 (95% CI 1.27-2.50)
Absolute Event Rate: 20% vs 13%
p-value: p=0.001
RA is feasible in octogenarian and nonagenarian patients, with in-hospital adverse outcomes comparable to those of younger patients. Advanced age remains a strong predictor of 1-year MACE, given its inherently higher mortality. Graphical abstract available for this article.
Samy et al. (Thu,) conducted a observational in Patients presenting with acute coronary syndrome and severely calcified coronary lesions treated with rotational atherectomy, divided into octogenarians/nonagenarians (age ≥80 years) and younger adults (age <80 years) (n=785). Rotational atherectomy (RA) vs. Younger patients (<80 years) treated with RA was evaluated on Major adverse cardiac events (MACE), composite of cardiac death, spontaneous myocardial infarction (MI), or target lesion revascularization (TLR) at 1 year (adj. HR 1.78, 95% CI 1.27-2.50, p=0.001). Rotational atherectomy in octogenarians/nonagenarians increased 1-year MACE to 20% compared to 13% in younger patients, with adjusted HR 1.78 (95% CI 1.27-2.50, p=0.001).