What question did this study set out to answer?

This study aims to evaluate the effects of percutaneous coronary intervention (PCI) in nonagenarians with acute myocardial infarction (AMI).

January 10, 2026Scientific Reports0 citationsOpen Access

Percutaneous coronary intervention in nonagenarians with acute myocardial infarction: a 15-year population-based study

GMGiancarlo Silvio MarenziCentro Cardiologico Monzino NCNicola CosentinoInterventional Cardiology DMDaniela MelePolytechnic University of Puerto Rico

Key Result

Percutaneous coronary intervention in nonagenarians with acute myocardial infarction reduced in-hospital mortality to 15% compared to 23% without PCI (P < 0.0001).

Key Points

This study aims to evaluate the effects of percutaneous coronary intervention (PCI) in nonagenarians with acute myocardial infarction (AMI).
Utilized data from the Lombardy Health Database for patients hospitalized between 2003 and 2018.
Analyzed outcomes in a large cohort of patients with AMI, focusing on PCI usage and mortality rates.
Conducted adjusted risk analyses and propensity score matching for robust comparisons.
In-hospital mortality was significantly lower in PCI-treated patients (15% vs. 23%, P < 0.0001).
One-year mortality was reduced to 37% among PCI patients compared to 58% for non-PCI patients (P < 0.0001).
Rehospitalization rates for acute heart failure or AMI were lower among PCI patients (16% vs. 21%).
The use of PCI increased from 4% in 2003 to 22% in 2018, with concurrent declines in in-hospital mortality.

Structured PICO

Does percutaneous coronary intervention reduce mortality and rehospitalization in AMI patients older than 90 years?

Population

15,954 patients >90 years old (median age 92, 71% female) hospitalized with acute myocardial infarction (50% STEMI, 50% NSTEMI) between 2003 and 2018 in Lombardy, Italy.

Intervention

Percutaneous coronary intervention (PCI)

Comparator

Medical therapy without percutaneous coronary intervention

Outcome

In-hospital mortalityhard clinical

In nonagenarians with acute myocardial infarction, percutaneous coronary intervention is associated with significantly lower in-hospital and 1-year mortality compared to medical therapy alone, suggesting age alone should not preclude invasive management.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

The use of percutaneous coronary intervention (PCI) in very elderly patients (> 90 years) with acute myocardial infarction (AMI) remains debated due to limited evidence and the presence of multimorbidity. This study evaluated the impact of PCI using data from the Lombardy Health Database (Italy) for AMI patients hospitalized between 2003 and 2018. Among 15,954 patients (median age 92; 71% female; 50% with ST-elevation myocardial infarction STEMI), 12% underwent PCI. In-hospital mortality was lower in PCI-treated patients (15% vs. 23%; P < 0.0001). Overall, one-year mortality (56%) and rehospitalization for acute heart failure (AHF) or AMI (19%) were also reduced among PCI patients (37% vs. 58% and 16% vs. 21%, respectively; P < 0.0001). These findings were consistent across both STEMI and non-ST-elevation myocardial infarction (NSTEMI) subgroups and were independent of comorbidities. Adjusted risk analyses and propensity score matching (1,950 patients per group) confirmed these benefits. The use of PCI increased significantly from 4% in 2003 to 22% in 2018, while in-hospital mortality declined from 22 to 19% (from 28 to 15% in the propensity-matched cohort). In conclusion, PCI was associated with significantly lower in-hospital and one-year mortality, as well as reduced rehospitalization rates, in AMI patients older than 90 years, regardless of comorbidities.

Ask AI

Helpful

Bookmark

View Full Paper