What is the clinical evidence from this study?

Study design: Cohort. Population: coronary artery disease (n=65). Intervention: Percutaneous coronary interventions (PCI) vs. Stable angina vs emergent PCI. Primary outcome: 6-month cumulative mortality.

What question did this study set out to answer?

To evaluate acute and intermediate-term clinical outcomes among nonagenarian patients undergoing percutaneous coronary intervention.

July 9, 2007Catheterization and Cardiovascular Interventions

Results of percutaneous coronary interventions in patients ≥90 years of age

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Key result

Percutaneous coronary intervention in nonagenarians yielded a 6-month mortality of 18% overall, with 0% mortality in stable angina patients versus 23% in emergent PCI scenarios.

Why the study?

Does percutaneous coronary intervention improve clinical outcomes in patients aged >=90 years?

Population

65 consecutive patients, age >= 90 years undergoing percutaneous coronary interventions. Clinical…

Design

Cohort

Follow-up

6 months

Authors

ITIgal TeplitskyTel Aviv University AAAbid AssaliTel Aviv University ELEli I. LevInterventional / Structural Cardiology

Discussion

Member takes

Implication

Supports selective PCI consideration in stable nonagenarians; leaves open randomized trials versus medical therapy.

Key Points

To evaluate acute and intermediate-term clinical outcomes among nonagenarian patients undergoing percutaneous coronary intervention.
Analyzed 65 consecutive patients aged ≥90 years undergoing percutaneous coronary intervention between January 2001 and August 2006.
Tracked clinical presentations including ST-elevation myocardial infarction (n=14), non-ST-elevation myocardial infarction (n=39), cardiogenic shock (n=1), and severe stable angina (n=12).
Recorded angiographic lesion complexity, procedural success rates, in-hospital complications, and clinical outcomes through six months of follow-up.
Immediate procedural success occurred in 92% of cases despite multivessel coronary disease in 86% and complex type B/C lesions in 94%.
Cumulative mortality was 14% in-hospital and at 30 days, increasing to 18% at 6 months, while major adverse cardiac events reached 17% in-hospital and 21% at 6 months.
Six-month mortality was 0% among patients presenting with stable angina compared to 23% in those undergoing emergent intervention for acute coronary syndromes.

Study Design

Type

Cohort (n=65)

Structured PICO

Does percutaneous coronary intervention improve clinical outcomes in patients aged >=90 years?

Population

65 consecutive patients, age >= 90 years undergoing percutaneous coronary interventions (PCI). Clinical presentations included acute ST elevation myocardial infarction (n=14), cardiogenic shock (n=1), non-STEAMI (n=39), and severe stable angina pectoris (n=12).

Intervention

Percutaneous coronary intervention (PCI), with stent deployment in 92% of patients and intra-aortic balloon pump (IABP) needed in 7% of cases.

Outcome

Acute and intermediate term clinical outcomes, including procedural success, in-hospital and 6-month mortality, and major adverse cardiac events (MACE: death, AMI, TVR, stroke).hard clinical

PCI in nonagenarians is associated with excellent outcomes in clinically stable patients, but carries a higher mortality risk in emergent, unstable presentations.

Cite This Study

Teplitsky et al. (2007) conducted a cohort in coronary artery disease (n=65). Percutaneous coronary interventions (PCI) vs. Stable angina vs emergent PCI was evaluated on 6-month cumulative mortality. Percutaneous coronary intervention in nonagenarians yielded a 6-month mortality of 18% overall, with 0% mortality in stable angina patients versus 23% in emergent PCI scenarios.

synapsesocial.com/papers/6a10bff08102eb4b66ee4ff6 https://doi.org/10.1002/ccd.21263

Topics

Coronary artery disease

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Results of percutaneous coronary interventions in patients ≥90 years of age

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Topics

Results of percutaneous coronary interventions in patients ≥90 years of age

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider