Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor, Michigan 48109-5853, USA.
Clin Cardiol. 2011 Sep;34(9):549-54. doi: 10.1002/clc.20926. Epub 2011 Jun 29.
There is a paucity of data on the outcome of contemporary percutaneous coronary intervention (PCI) in the elderly. Accordingly, we assessed the impact of age on outcome of a large cohort of patients undergoing PCI in a regional collaborative registry.
Increasing age is associated with a higher incidence of procedural-related complications.
We evaluated the outcome of 152,373 patients who underwent PCI from 2003 to 2008 in the 31 hospitals participating in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium. The procedural outcomes of the cohort were compared by dividing patients into < 70 years of age, 70 to 79 years, 80 to 84 years, 85 to 89 years, and ≥ 90 years.
Of the cohort, 64.64% were <70 years of age, 23.83% were 70 to 79 years, 7.85% were 80 to 84 years, 3.09% were 85 to 89 years, and 0.58% were 90 years or older. Increasing age was associated with an increase in all-cause in-hospital mortality, contrast-induced nephropathy, transfusion, stroke/transient ischemic attack, and vascular complications. The overall in-hospital mortality rate was 1.09% and increased from 0.67% in those younger than 70 years up to 5.44% in those 90 years old or greater. The mortality rate in patients over 80 years approached 12% to 15% for those with ST-segment myocardial infarction and 39% in cardiogenic shock patients.
The proportion of elderly patients referred for PCI is increasing. Procedural complications increase with age, and patients presenting with unstable symptoms are at the highest risk.
目前关于当代经皮冠状动脉介入治疗（PCI）在老年人中的结果的数据很少。因此，我们评估了在一个区域性合作注册中心中，大量接受 PCI 的患者的年龄对结果的影响。
年龄的增加与更高的与手术相关的并发症发生率相关。
我们评估了 2003 年至 2008 年间在密歇根蓝十字蓝盾心血管联合会的 31 家医院参与的 PCI 患者 152373 例的结果。通过将患者分为<70 岁、70-79 岁、80-84 岁、85-89 岁和≥90 岁，比较了队列的手术结果。
队列中 64.64%的患者<70 岁，23.83%的患者 70-79 岁，7.85%的患者 80-84 岁，3.09%的患者 85-89 岁，0.58%的患者 90 岁或以上。年龄的增加与全因住院死亡率、对比剂诱导的肾病、输血、卒中和短暂性脑缺血发作以及血管并发症的增加相关。总的住院死亡率为 1.09%，从<70 岁的 0.67%上升到 90 岁以上的 5.44%。80 岁以上患者的死亡率在 ST 段抬高型心肌梗死患者中接近 12%至 15%，在心源性休克患者中达到 39%。
转诊接受 PCI 的老年患者比例在增加。手术并发症随年龄增加而增加，有不稳定症状的患者风险最高。
