Predictors of early and late outcome of percutaneous coronary intervention in octogenarians

OBJECTIVE: To evaluate the short and long-term results of percutaneous coronary interventions (PCI) in patients aged 80 years or older and to identify predictors of event-free survival. METHODS AND RESULTS: Clinical and angiographic data from all patients undergoing percutaneous coronary intervention in our institution are prospectively collected and stored in a computerized database. The clinical and angiographic characteristics of all patients aged 80 years or older undergoing percutaneous coronary intervention between January 1994 and December 1999 were analysed retrospectively. Follow-up was obtained by interview or through the referring physician. One hundred and fifty-eight patients aged 80 years or older (median: 83.4; range: 80.2-92.2) underwent percutaneous coronary intervention in our institution during the study period. The initial angiographic success rate was 92%. In-hospital mortality was 8.2% and procedural success 84.8%. One-year and two-year survival were 81% and 72.2% respectively, while event free survival at 1 year and 2 years was 65.8% and 57%. Using the Cox proportional hazards method, we identified incomplete revascularization and low left ventricular ejection fraction (LVEF) as predictors of death at 2 years. Complete revascularization and stenting were independent predictors of 2-year event-free survival. CONCLUSION: Percutaneous coronary intervention can be performed safely in octogenarians. Complete revascularization, stenting and preserved left ventricular ejection fraction were independent predictors of better outcome in this population.