Why the study?
Older adults undergoing complex, high-risk PCI face the highest risk for morbidity and mortality, but conventional risk assessment tools omit geriatric syndromes which can supersede other risk aspects.
Proposes adding geriatric syndromes as a fourth pillar to conventional risk assessment tools for older adults undergoing PCI.
Adding geriatric syndromes to PCI risk tools in older adults is hypothesis-generating; leaves open incremental value pending prospective validation.
As the population ages, older adults represent an increasing proportion of patients referred to the cardiac catheterization laboratory. Older adults are the highest-risk group for morbidity and mortality, particularly after complex, high-risk percutaneous coronary interventions. Structured risk assessment plays a key role in differentiating patients who are likely to derive net benefit vs those who have disproportionate risks for harm. Conventional risk assessment tools from national cardiovascular societies typically rely on 3 pillars: 1) cardiovascular risk; 2) physiologic and hemodynamic risk; and 3) anatomic and procedural risks. We propose adding a fourth pillar: geriatric syndromes, as geriatric domains can supersede all other aspects of risk.
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Nanna et al. (2023) studied this question.
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