Patients aged 65 years undergoing PCI had significantly higher all-cause mortality at long-term follow-up (19.4%) compared to those <85 years (5.9%) with a hazard ratio of 3.332 (95% CI 3.064-3.624, P<0.001).
Cohort (n=155,683)
Yes
Does percutaneous coronary intervention in patients aged ≥ 85 years compared to those < 85 years result in higher mortality and adverse cardiovascular events?
Patients aged 85 years and older undergoing PCI have a significantly higher risk of short- and long-term mortality compared to younger patients, emphasizing the need for individualized risk-benefit assessments incorporating frailty.
Effect estimate: HR 3.332 (95% CI 3.064-3.624)
Absolute Event Rate: 19.4% vs 5.9%
p-value: p=<0.001
Background In patients with coronary artery disease, age is of known significance in predicting outcomes. Data on clinical outcomes in patients ≥ 85 years undergoing percutaneous coronary intervention (PCI) remain scarce. The study aim was to determine clinical characteristics, risk of adverse cardiovascular events, and mortality in patients aged ≥ 85 years compared to those aged Methods In this retrospective study, data were obtained from the nationwide Netherlands Heart Registration on patients undergoing PCI between January 1st, 2017 and January 1st, 2021. The primary endpoint was all-cause mortality at long-term follow-up. Results A total of 155,683 patients underwent PCI, of which 100,209 (64.4%) acute coronary syndrome cases. Compared to patients aged P vs. 0.7%; P = 0.024), though they less often underwent revascularization at long-term follow-up compared to patients aged P Conclusions The elderly (≥ 85 years) patient requiring PCI carries an extensive cardiovascular risk profile, translating in significant risk of recurrent cardiovascular events and increased mortality rate. Clinicians should carefully weigh perceived risks and potential benefits in the individual patient, considering the patients’ age, cardiovascular risk profile, and associated risk of morbidity and mortality.
Vranken et al. (Thu,) conducted a cohort in Patients undergoing percutaneous coronary intervention (PCI) in the Netherlands, divided into those aged <85 years and those aged 65 years (n=155,683). Percutaneous coronary intervention (PCI) vs. PCI patients aged <85 years versus 65 years was evaluated on All-cause mortality at long-term follow-up after index PCI (HR 3.332, 95% CI 3.064-3.624, p=<0.001). Patients aged 65 years undergoing PCI had significantly higher all-cause mortality at long-term follow-up (19.4%) compared to those <85 years (5.9%) with a hazard ratio of 3.332 (95% CI 3.064-3.624, P<0.001).