What is the clinical evidence from this study?

Study design: Cohort. Population: Coronary artery disease in nonagenarians (n=107). Intervention: Percutaneous coronary intervention (PCI). Primary outcome: One-year mortality (p=0.227).

What question did this study set out to answer?

To evaluate the safety, clinical efficacy, and one-year outcomes of percutaneous coronary intervention in patients aged 90 years and older.

June 2, 2025Scandinavian Cardiovascular Journal

Percutaneous coronary intervention in nonagenarians

Q: What does this research mean for the field?

Percutaneous coronary intervention in nonagenarians is associated with acceptable mortality and 1-year rates of myocardial infarction (7.5%), stroke (1.9%), and repeat revascularisation (3.7%), supporting its use in selected patients. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

PCI in nonagenarians is linked to a ~8% one-year MI rate, alongside stroke and repeat revascularization.

P=0.227
n=107

Why the study?

Nonagenarians are increasingly undergoing PCI, but the safety and efficacy of PCI in this elderly population remains somewhat unknown.

Does percutaneous coronary intervention improve one-year mortality in nonagenarians?

Key Points

To evaluate the safety, clinical efficacy, and one-year outcomes of percutaneous coronary intervention in patients aged 90 years and older.
Analyzed 107 nonagenarians (mean age 91.2 ± 1.4 years; 58.9% women) undergoing percutaneous coronary intervention.
Stratified patients into three clinical presentation cohorts: ST-elevation myocardial infarction (STEMI), non-ST-elevation acute coronary syndrome (NSTEACS), and stable coronary artery disease (CAD).
Evaluated primary endpoint of one-year mortality alongside secondary endpoints of in-hospital major bleeding, one-year myocardial infarction, stroke, and repeat revascularisation.
One-year post-procedure adverse event rates were 7.5% for myocardial infarction, 1.9% for stroke, and 3.7% for repeat revascularisation (P=0.227).
Excess mortality was concentrated primarily in patients presenting with STEMI, driven predominantly by early adverse events.

Study Design

Type

Cohort (n=107)

Structured PICO

Does percutaneous coronary intervention improve one-year mortality in nonagenarians?

Population

107 nonagenarians (mean age 91.2 ± 1.4 years; 58.9% women) presenting with ST-elevation myocardial infarction (STEMI), non-ST-elevation acute coronary syndrome (NSTEACS) or stable coronary artery disease (CAD)

Intervention

Percutaneous coronary intervention (PCI)

Outcome

One-year mortalityhard clinical

Main Result

p-value: p=0.227

PCI in selected nonagenarians demonstrates acceptable 1-year mortality and complication rates, supporting its use in this elderly population, though STEMI presentation carries higher early mortality risk.

Implication

PCI feasible in selected nonagenarians; leaves open survival benefit versus medical therapy.

Abstract

BACKGROUND: Due to aging population, nonagenarians are increasingly undergoing percutaneous coronary intervention (PCI). However, the safety and efficacy of PCI in this elderly population remains somewhat unknown. METHODS: = 107; mean age 91.2 ± 1.4 years; 58.9% women) were stratified into three groups based on their presentation: ST-elevation myocardial infarction (STEMI), non-ST-elevation acute coronary syndrome (NSTEACS) or stable coronary artery disease (CAD). One-year mortality was the primary outcome of this analysis. Secondary outcomes were in-hospital major bleeding and 1-year rates of myocardial infarction, stroke and repeat revascularisation. RESULTS: = 0.227). One-year rates for myocardial infarction, stroke and repeat revascularisation were 7.5%, 1.9% and 3.7%, respectively. CONCLUSIONS: Excess mortality in nonagenarians undergoing PCI is mainly related to STEMI where it is driven by early adverse events. Mortality in this study can be seen as acceptable in comparison to that in general population, supporting the use of PCI in selected nonagenarians.

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Cite This Study

Riihiniemi et al. (2025) conducted a cohort in Coronary artery disease in nonagenarians (n=107). Percutaneous coronary intervention (PCI) was evaluated on One-year mortality (p=0.227). Percutaneous coronary intervention in nonagenarians was associated with 1-year rates of myocardial infarction (7.5%), stroke (1.9%), and repeat revascularisation (3.7%).

synapsesocial.com/papers/6a124fed92637892a9a643b6 https://doi.org/10.1080/14017431.2025.2514880